This bill proposes the imposition of an assessment on Minnesota hospitals that participate in the state's Medical Assistance program. The revenue generated from this assessment would be used to fund the non-federal share of a hospital directed payment program.

Key provisions of the bill include:

1. Assessment Calculation: Eligible hospitals must pay an assessment based on a percentage of their net inpatient and outpatient revenues, as reported in their most recent Medicare cost report.
2. Payment Schedule: Assessments are due quarterly (January 1, April 1, July 1, and October 1), with invoices sent out the preceding month.
3. Notification and Adjustments: Hospitals will be notified of estimated assessment amounts for the following year by October 15. If a hospital underpays or overpays, the commissioner will notify the facility, and disputes can be resolved using existing legal remedies related to provider payments.
4. Usage Restrictions: Funds collected from the assessment can only be used to pay the non-federal share of the directed payment program.
5. Restrictions on Collection: The state cannot collect assessments if federal financial participation is unavailable or if the payment program is not approved by the Centers for Medicare and Medicaid Services (CMS).
6. Exemptions and Discounts: Certain hospitals, including long-term care hospitals, critical access hospitals in rural Minnesota, children’s hospitals, Indian Health Service facilities, and state-owned facilities, are exempt from the assessment or eligible for discounts. Special provisions also apply for teaching hospitals with high Medicaid usage and trauma centers.
7. Cap on Contributions: The assessment will be adjusted to ensure that no single hospital system contributes more than a predetermined percentage of the total collected.
8. Adjustments Based on Need: The total assessments can be reduced to ensure that total collections do not exceed what is necessary for the non-federal share of directed payments.
9. Reporting Requirements: Hospitals subject to the assessment must submit documentation annually to determine the appropriate amounts.

The bill seeks to create a new subdivision in Minnesota’s statutory framework to formalize this hospital assessment and payment structure.