{"data":{"id":"us-ok/okla.-stat.-tit.-63-63-3241.3","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 63, § 63-3241.3","heading":"Hospital assessment - Exceptions - Fees - Promulgation","body":"of rules.\n\nA. For the purpose of assuring access to quality care for\n\nOklahoma Medicaid consumers, the Oklahoma Health Care Authority,\n\nafter considering input and recommendations from the Hospital\n\nAdvisory Committee, shall assess hospitals licensed in Oklahoma,\n\nunless exempt under subsection B of this section, a supplemental\n\nhospital offset payment program fee.\n\nB. The following hospitals shall be exempt from the\n\nsupplemental hospital offset payment program fee:\n\n1. A hospital that is owned or operated by the state or a state\n\nagency, the federal government, a federally recognized Indian tribe,\n\nor the Indian Health Service;\n\n2. A hospital that provides more than fifty percent (50%) of\n\nits inpatient days under a contract with a state agency other than\n\nthe Authority;\n\n3. A hospital for which the majority of its inpatient days are\n\nfor any one of the following services, as determined by the\n\nAuthority using the Inpatient Discharge Data File published by the\n\nState Department of Health, or in the case of a hospital not\n\nincluded in the Inpatient Discharge Data File, using substantially\n\nequivalent data provided by the hospital:\n\na. treatment of a neurological injury,\n\nb. treatment of cancer,\n\nc. treatment of cardiovascular disease,\n\nd. obstetrical or childbirth services, and\n\ne. surgical care, except that this exemption shall not\n\napply to any hospital located in a city of less than\n\nfive hundred thousand (500,000) population and for\n\nwhich the majority of inpatient days are for back,\n\nneck, or spine surgery;\n\n4. A hospital that is certified by the federal Centers for\n\nMedicare and Medicaid Services as a long-term acute care hospital or\n\nas a children's hospital; and\n\n5. A hospital that is certified by the federal Centers for\n\nMedicare and Medicaid Services as a critical access hospital.\n\nC. The supplemental hospital offset payment program fee shall\n\nbe an assessment imposed on each eligible hospital, except those\n\nexempted under subsection B of this section, for each calendar year\n\nin an amount calculated as a percentage of each eligible hospital's\n\nnet hospital patient revenue.\n\n1. Funds generated by the supplemental hospital offset payment\n\nprogram fee shall be disbursed for the following purposes in the\n\nfollowing priority order:\n\na. One Hundred Thirty Million Dollars ($130,000,000.00)\n\nto be transferred annually to the Medical Payments\n\nCash Management Improvement Act Programs Disbursing\n\nFund to fund the state Medicaid program,\n\nb. the nonfederal share of:\n\n(1) the upper payment limit gap,\n\n(2) the managed care gap,\n\n(3) the managed care provider incentive pool to\n\nsupport health care quality assurance and access\n\nimprovement initiatives, with the pool amount\n\ndetermined by the representative sharing ratio of\n\nprovider and hospital participation in Medicaid.\n\nProvider eligibility shall be determined by the\n\nAuthority. For purposes of this division,\n\neligible providers shall not include those\n\nemployed by or contracted with, or otherwise a\n\nmember of, the faculty practice plan of either:\n\n(a) a public, accredited Oklahoma medical\n\nschool, or\npool amount\n\ndetermined by the representative sharing ratio of\n\nprovider and hospital participation in Medicaid.\n\nProvider eligibility shall be determined by the\n\nAuthority. For purposes of this division,\n\neligible providers shall not include those\n\nemployed by or contracted with, or otherwise a\n\nmember of, the faculty practice plan of either:\n\n(a) a public, accredited Oklahoma medical\n\nschool, or\n\n(b) a hospital or health care entity directly or\n\nindirectly owned or operated by the entities\n\ncreated pursuant to Section 3224 or 3290 of\n\nthis title,\n\n(4) the annual fee to be paid to the Authority under\n\nsubparagraph c of paragraph 1 of subsection G of\n\nSection 3241.4 of this title, and\n\n(5) Thirty Million Dollars ($30,000,000.00) annually\n\nto be transferred by the Authority to the Medical\n\nPayments Cash Management Improvement Act Programs\n\nDisbursing Fund under subsection C of Section\n\n3241.4 of this title.\n\nIf the nonfederal share generated by the supplemental\n\nhospital offset payment program fee is not sufficient\n\nto fully fund the disbursements described in divisions\n\n1 through 5 of this subparagraph, the funds directed\n\ntoward such disbursements shall be reduced\n\nproportionally, and\n\nc. any remaining funds shall be deposited into the\n\nMedicaid Health Improvement Revolving Fund created in\n\nSection 23 of Enrolled Senate Bill No. 1337 of the 2nd\n\nSession of the 58th Oklahoma Legislature.\n\n2. The assessment rate until December 31, 2012, shall be fixed\n\nat two and one-half percent (2.5%). For the calendar year ending\n\nDecember 31, 2022, the assessment rate shall be fixed at three\n\npercent (3%). For the calendar year ending December 31, 2023, the\n\nassessment rate shall be fixed at three and one-half percent (3.5%).\n\nFor the calendar year ending December 31, 2024 and for all\n\nsubsequent calendar years, the assessment rate shall be fixed at\n\nfour percent (4%).\n\n3. Net hospital patient revenue shall be determined using the\n\ndata from each eligible hospital's Medicare Cost Report contained in\n\nthe federal Centers for Medicare and Medicaid Services' Healthcare\n\nCost Report Information System file.\n\na. Through 2013, the base year for assessment shall be\n\nthe eligible hospital's fiscal year that ended in\n\n2009, as contained in the Healthcare Cost Report\n\nInformation System file dated December 31, 2010.\n\nb. For years after 2013, the base year for assessment\n\nshall be determined by rules established by the\n\nOklahoma Health Care Authority Board and beginning\n\nJanuary 1, 2022, the base year for assessment shall be\n\ndetermined annually.\n\n4. If an eligible hospital's applicable Medicare Cost Report is\n\nnot contained in the federal Centers for Medicare and Medicaid\n\nServices' Healthcare Cost Report Information System file, the\n\neligible hospital shall submit a copy of its applicable Medicare\n\nCost Report to the Authority in order to allow the Authority to\n\ndetermine the eligible hospital's net hospital patient revenue for\n\nthe base year.\n\n5. If an eligible hospital commenced operations after the due\n\ndate for a Medicare Cost Report, the eligible hospital shall submit\n\nits initial Medicare Cost Report to the Authority in order to allow\n\nthe Authority to determine the hospital's net patient revenue for\n\nthe base year.\n\n6. Partial year reports may be prorated for an annual basis.\n\n7. In the event that an eligible hospital does not file a\n\nuniform cost report under 42 U.S.C., Section 1396a(a)(40), the\n\nAuthority shall establish a uniform cost report for such facility\n\nsubject to the Supplemental Hospital Offset Payment Program provided\n\nfor in this section.\n\n8. The Authority shall review which hospitals are eligible to\n\nparticipate in the Supplemental Hospital Offset Payment Program\n\nprovided for in this subsection and which hospitals are exempted\n\npursuant to subsection B of this section. Such review shall occur\npplemental Hospital Offset Payment Program provided\n\nfor in this section.\n\n8. The Authority shall review which hospitals are eligible to\n\nparticipate in the Supplemental Hospital Offset Payment Program\n\nprovided for in this subsection and which hospitals are exempted\n\npursuant to subsection B of this section. Such review shall occur\n\nat a fixed period of time. This review and decision shall occur\n\nwithin twenty (20) days of the time of federal approval and annually\n\nthereafter in November of each year.\n\n9. The Authority shall review and determine the amount of the\n\nannual assessment. Such review and determination shall occur within\n\nthe twenty (20) days of federal approval and annually thereafter in\n\nNovember of each year.\n\nD. An eligible hospital may not charge any patient for any\n\nportion of the supplemental hospital offset payment program fee.\n\nE. Closure, merger and new hospitals.\n\n1. If an eligible hospital ceases to be an eligible hospital\n\nfor any reason, the assessment for the year in which the cessation\n\noccurs shall be adjusted by multiplying the annual assessment by a\n\nfraction, the numerator of which is the number of days in the year\n\nduring which the hospital is subject to the assessment and the\n\ndenominator of which is 365. Immediately upon ceasing to be an\n\neligible hospital, the hospital shall pay the assessment for the\n\nyear as adjusted, to the extent not previously paid.\n\n2. In the case of an eligible hospital that did not operate as\n\na hospital throughout the base year, its assessment and any\n\npotential receipt of a hospital access payment will commence in\n\naccordance with rules for implementation and enforcement promulgated\n\nby the Oklahoma Health Care Authority Board, after consideration of\n\nthe input and recommendations of the Hospital Advisory Committee.\n\nF. 1. In the event that federal financial participation\n\npursuant to Title XIX of the Social Security Act is not available to\n\nthe Oklahoma Medicaid program for purposes of matching expenditures\n\nfrom the Supplemental Hospital Offset Payment Program Fund at the\n\napproved federal medical assistance percentage for the applicable\n\nyear for one or more of the purposes identified in division 1, 2, or\n\n3 of subparagraph b of paragraph 1 of subsection C of this section,\n\nthe portion of the supplemental hospital offset payment program fee\n\nattributable to any such purpose for which matching expenditures are\n\nunavailable shall be null and void as of the date of the\n\nnonavailability of such federal funding through and during any\n\nperiod of nonavailability.\n\n2. In the event of an invalidation of the Supplemental Hospital\n\nOffset Payment Program Act by any court of last resort, the\n\nsupplemental hospital offset payment program fee shall be null and\n\nvoid as of the effective date of that invalidation.\n\n3. In the event that the supplemental hospital offset payment\n\nprogram fee is determined to be null and void for any of the reasons\n\nenumerated in this subsection, any supplemental hospital offset\n\npayment program fee assessed and collected for any period after such\n\ninvalidation shall be returned in full within twenty (20) days by\n\nthe Authority to the eligible hospital from which it was collected.\n\nG. The Oklahoma Health Care Authority Board, after considering\n\nthe input and recommendations of the Hospital Advisory Committee,\n\nshall promulgate rules for the implementation and enforcement of the\n\nsupplemental hospital offset payment program fee. Unless otherwise\n\nprovided, the rules adopted under this subsection shall not grant\n\nany exceptions to or exemptions from the hospital assessment imposed\n\nunder this section.\n\nH. The Authority shall provide for administrative penalties in\n\nthe event a hospital fails to:\n\n1. Submit the supplemental hospital offset payment program fee\n\nin a timely manner; or\nntal hospital offset payment program fee. Unless otherwise\n\nprovided, the rules adopted under this subsection shall not grant\n\nany exceptions to or exemptions from the hospital assessment imposed\n\nunder this section.\n\nH. The Authority shall provide for administrative penalties in\n\nthe event a hospital fails to:\n\n1. Submit the supplemental hospital offset payment program fee\n\nin a timely manner; or\n\n2. Submit reports as required by this section in a timely\n\nmanner.\n\nI. The Oklahoma Health Care Authority Board shall have the\n\npower to promulgate emergency rules to implement the provisions of\n\nthe Supplemental Hospital Offset Payment Program Act.","path":["OK Code","Title 63"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os63.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"28ff0f47a8855a3e132571df690b4f5d4ff4f82785175b5713c9584cf1b6ea61","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-63-63-3241.2","next":"us-ok/okla.-stat.-tit.-63-63-3241.4"},"notice":"GroundRules: Original legal text. Not legal advice."}