Guam § 58128 - Unpledged Business Privilege Tax Rebate on Medicaid Receipts.

§ 58128. Unpledged Business Privilege Tax Rebate on Medicaid Receipts.

(a) Title. This Section shall be known and may be cited as the “Guam Medicaid Access Enhancement

Act.”

(b) Definitions. For purposes of this Section:

(1) “Healthcare provider” means any individual, partnership, corporation, association, or other

entity that is licensed, certified, or otherwise authorized by the government of Guam to provide

healthcare services on Guam.

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(2) “Medicaid receipts” means the gross receipts received by a healthcare provider for services

provided to patients enrolled in the Medicaid program, including any federal or local Medicaid

expansion or waiver programs.

(3) “Qualified healthcare professional” means any individual who is registered with the Guam

Board of Medical Examiners, the Guam Allied Health Board, the Guam Board of Nurse Examiners,

the Guam Board of Dental Examiners, or the Guam Board of Pharmacy, and who provides services to

Medicaid patients.

(4) “Service location” means a physical location on Guam where a healthcare provider delivers

healthcare services to Medicaid patients. To qualify as a separate service location, each facility must:

(A) be physically separate from other qualifying service locations;

(B) have regular, published hours of operation;

(C) have appropriate facilities and equipment for providing healthcare services; and

(D) be staffed by at least one (1) qualified healthcare professional.

(c) Unpledged Business Privilege Tax Rebate on Medicaid Receipts. Notwithstanding any other

provision of law, a healthcare provider shall be entitled to the following rebates on business privilege taxes

owed on Medicaid receipts:

(1) Base Rebate: A rebate of twenty percent (20%) of all Medicaid receipts;

(2) Professional Rebate: An additional rebate of twenty percent (20%) of all Medicaid receipts

for each qualified healthcare professional employed by, or exclusively independently contracted to,

the healthcare provider who services Medicaid patients;

(3) Location Rebate: An additional rebate of twenty percent (20%) of all Medicaid receipts for

each physical service location on Guam that services Medicaid patients; and

(4) Any rebate authorized in this Act shall not include the federal share of any Medicaid payment.

(d) Maximum Rebate. The total rebate under Subsection (c) shall not exceed the total amount of

business privilege tax owed on Medicaid receipts.

(e) Application and Certification.

(1) The Guam Economic Development Authority (GEDA) shall establish the application

requirements and procedures pursuant to the unpledged business privilege tax rebate on Medicaid

receipts.

(2) To claim the rebates provided under this Section, a healthcare provider shall submit an

application to the Guam Economic Development Authority on an annual basis, in a form and manner

prescribed by the Administrator.

(3) The application shall include:

(A) documentation of the healthcare provider’s total Medicaid receipts for the applicable tax

period;

(B) a list of all qualified healthcare professionals employed by or affiliated with the

healthcare provider who service Medicaid patients, including their license or registration numbers

with the applicable professional board;

(C) a list and description of all physical service locations on Guam where the healthcare

provider delivers services to Medicaid patients; and

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(D) any other information deemed necessary by the Administrator to verify eligibility for the

rebates.

(4) The Guam Economic Development Authority shall consult with the Department of Public

Health and Social Services to verify the accuracy of information provided in the application.

(f) Audit and Compliance.

(1) The Guam Economic Development Authority, in coordination with the Department of Public

Health and Social Services, shall establish procedures for auditing healthcare providers claiming

rebates under this Section to ensure compliance with all requirements.

(2) Healthcare providers claiming rebates under this Section shall maintain records sufficient to

demonstrate compliance with the requirements of this Section for a period of at least three (3) years

after the end of the tax period for which the rebate is claimed.

(3) Any healthcare provider who knowingly provides false information to obtain rebates under

this Section shall be subject to:

(A) repayment of all rebates improperly received, plus interest at the rate of ten percent

(10%) per annum;

(B) a penalty equal to fifty percent (50%) of all rebates improperly received; and

(C) disqualification from receiving any rebates under this Section for a period of five (5)

years.

(g) Annual Report. The Guam Economic Development Authority, in collaboration with the

Department of Public Health and Social Services, shall submit an annual report based on filings pursuant

to this Section, to I Maga’hågan/Maga’låhen Guåhan and I Liheslaturan Guåhan by March 31 of each

year, beginning in 2026, detailing:

(1) the number of healthcare providers claiming rebates under this Section;

(2) the total amount of rebates granted under this Section;

(3) the number of qualified healthcare professionals servicing Medicaid patients;

(4) the number of service locations providing care to Medicaid patients;

(5) the number of healthcare providers utilizing the self-certification option and their progress

toward meeting certification requirements;

(6) the results of audits conducted on self-certified providers, including compliance rates and

penalties assessed; and

(7) an assessment of the impact of this Section on Medicaid access and service delivery.

(h) Rules and Regulations. The Guam Economic Development Authority, in consultation with the

Department of Public Health and Social Services, shall promulgate rules and regulations in accordance with

the Administrative Adjudication Law to implement the provisions of this Section within ninety (90) days

of the effective date of this Act.