Cash Receipts Assessment Program

September 22, 2005

Dear Administrator/Controller:

Re: Cash Receipts Assessment Program for Hospitals

You were advised in my letter dated May 4, 2005, that a .35% Cash Receipts Assessment was enacted for hospitals licensed under Article 28 of the Public Health Law (PHL) for the period April 1, 2005 through March 31, 2007. This is to provide you with a courtesy hard copy of the reporting forms and instructions for this program that you will find on the Pool Department's website at www.hcrapools.org.

webpools@hcrapools.org.

As previously stated in the May 4th letter, collection of this surcharge was deferred until December 2005. Your total obligation for the months of April through November 2005 may be paid in full along with your December 2005 liability or it may be paid in equal installments with your December 2005, January 2006 and February 2006 payments. To utilize an installment plan, complete all of the monthly reports and the Payment Allocation and Filing Schedule and submit them with the December 2005 report and payment.

Failure to timely file required reports and payments, including applicable retroactive installment amounts for April through November 2005, will result in the initiation of recoupment procedures against future Medicaid payments. All late payments will also be subject to additional penalty and interest obligations as required by governing statute.

If you should have any questions concerning the foregoing, please contact Mr. Walter Susko of my staff at (518) 474-1673.

Sincerely,

Mark H. Van Guysling
Assistant Director
Division of Health Care Financing

Enclosures