New Jersey § 26:2h-18

§ 26:2h-18.

a. Beginning July 1, 2004 and each year thereafter: (1) Reimbursed documented charity care shall be equal to the Medicaid-priced amounts

of charity care claims submitted to the Department of Health for the most recent calendar

year, adjusted, as necessary, to reflect the annual audit results. These amounts shall be augmented to reflect payments to hospitals by the Medicaid

program for Graduate Medical Education and Indirect Medical Education based on the

most recent Graduate Medical Education and Indirect Medical Education formulas utilized

by the federal Medicare program. (2) Hospital-specific reimbursed documented charity care shall be equal to the Medicaid-priced

dollar amount of charity care provided by a hospital as submitted to the Department

of Health for the most recent calendar year. A sample of the claims submitted by the hospital to the department shall be subject

to an annual audit conducted pursuant to applicable charity care eligibility criteria. b. Beginning July 1, 2004 and each year thereafter, the charity care subsidy shall

be determined according to the following methodology: (1) Each hospital shall be ranked in order of its hospital-specific, relative charity

care percentage, or RCCP, by dividing the amount of hospital-specific gross revenue

for charity care patients by the hospital's total gross revenue for all patients. (2) The 10 hospitals with the highest RCCPs shall receive a charity care payment equal to 96 percent of each hospital's hospital-specific reimbursed documented charity care. The hospital ranked number 11 shall receive a charity care payment equal to 94 percent of its hospital-specific reimbursed documented charity care, and each hospital ranked

number 12 and below shall receive two percentage points less than the hospital ranked immediately

above that hospital. (3) Notwithstanding the provisions of paragraph (2) of this subsection to the contrary,

each of the hospitals located in the 10 municipalities in the State with the lowest

median annual household income according to the most recent census data, shall be

ranked from the hospital with the highest hospital-specific reimbursed documented

charity care to the hospital with the lowest hospital-specific reimbursed documented

charity care. The hospital in each of the 10 municipalities, if any, with the highest documented

hospital-specific charity care shall receive a charity care payment equal to 96 percent of its hospital-specific reimbursed documented charity care. (4) Notwithstanding the provisions of this subsection to the contrary, no hospital

shall receive reimbursement for less than 43 percent of its hospital-specific reimbursed documented charity care. c. To ensure that charity care subsidy payments remain viable and appropriate, the

State shall maintain the charity care subsidy at an amount not less than 75 percent of the Medicaid-priced amounts of charity care provided by hospitals in the State. In addition, these amounts shall be augmented to reflect payments to hospitals by

the Medicaid program for Graduate Medical Education and Indirect Medical Education

based on the most recent Graduate Medical Education and Indirect Medical Education

formulas utilized by the federal Medicare program. d. Notwithstanding any other provisions of this section to the contrary, in the event

that the change from the charity care subsidy formula in effect for fiscal year 2004

to the formula established pursuant to this section in effect for fiscal year 2005,

reduces, for any reason, the amount of the charity care subsidy payment to a hospital

below the amount that the hospital received under the formula in effect in fiscal

year 2004, the hospital shall receive a payment equal to the amount it would have

received under the formula in effect for fiscal year 2004. e. The Legislature finds and declares that it is the intent of Legislature to provide

that the provisions of P.L.2021, c. 330, which increases by one the number of hospitals eligible for a charity care payment

equal to 96 percent of the hospital's hospital-specific reimbursed documented charity

care, shall apply to the newly eligible hospital's State fiscal year 2022 charity

care payment. Any State fiscal year 2022 charity care payment change resulting from this formula

modification shall be issued, as soon as practicable, in the form of a supplemental

payment to each impacted hospital.