Delaware General Assembly

Senate Finance 3/27/24

Awaiting consideration in Committee

3/19/24

S. McBride

Reps. Harris, Heffernan

Sen. Gay, Hansen, Hoffner, Huxtable, Lockman, Mantzavinos, Pinkney, Poore, Sokola, Sturgeon, Townsend
Reps. Baumbach, Griffith, Jones Giltner, Lambert, Morrison, Neal, Osienski, Phillips, Romer

AN ACT TO AMEND TITLES 16 AND 30 OF THE DELAWARE CODE RELATING TO HOSPITAL QUALITY ASSESSMENTS AND ESTABLISHMENT OF A HOSPITAL QUALITY AND HEALTH EQUITY FUND AND HOSPITAL QUALITY AND HEALTH EQUITY ASSESSMENT COMMISSION.

Healthcare facility assessments are currently the second largest source of funding for states’ shares of Medicaid costs, behind general funds. Today, 49 states have at least one facility assessment in place, including Delaware, while 34 states and Washington D.C. have 3 or more provider taxes. Delaware is one of only 6 states without a facility assessment on hospitals, causing the state to miss out on critical Medicaid funding that most states are already able to access. This Act creates the Hospital Quality Assessment, which places a 3.58% assessment on Delaware hospitals’ net patient revenues. Net funds generated by the Hospital Quality Assessment must be utilized in one of two ways, with the exception of 10% that may be used to support existing Medicaid obligations: (1) 53.5% must be used to increase the inpatient and outpatient payments to hospitals. (2) 46.5% must be deposited into the Hospital Quality and Health Equity Fund, to be used to develop or enhance funding for Medicaid initiatives, unlocking federal matching dollars. Funds may not be used to supplant or replace appropriations for programs in existence on the effective date of this Act. This Act also creates the Hospital Quality and Health Equity Assessment Commission, which includes state agency and hospital representation. The Commission is required to meet at least annually to monitor the implementation of the assessment. If the Centers for Medicare & Medicaid Services (CMS) determines that either the assessment or the expenditure of money does not satisfy eligibility requirements for federal financial participation or that modifications are necessary to assure continued eligibility for federal financial participation, the Commission shall develop and approve modifications to Chapter 66 of Title 30 of the Delaware Code and Subchapter II of Chapter 10 of Title 16 of the Delaware Code and submit the modifications to the General Assembly. These modifications will take effect as of July 1 of the ensuing fiscal year unless rejected in full by an act of the General Assembly. This Act requires a greater than majority vote for passage because § 11 of Article VIII of the Delaware Constitution requires the affirmative vote of three-fifths of the members elected to each house of the General Assembly to impose or levy a tax or license fee. This Act may be cited as the “Protect Medicaid Act of 2024”.

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Takes effect upon being signed into law

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