Indigent Care and Health Care Initiatives Surcharges by Payor

FOR SERVICES RENDERED 4/1/09 - 12/31/14

SURCHARGE PAYMENTS
TO PROVIDERS
SURCHARGE PAYMENTS
DIRECTLY TO
THE HCRA POOLS
PAYOR CATEGORIES INPATIENT HOSPITAL, OUTPATIENT HOSPITAL,
DIAGNOSTIC AND
TREATMENT CENTERS
INPATIENT HOSPITAL, OUTPATIENT HOSPITAL,
DIAGNOSTIC AND
TREATMENT CENTERS
FOR SERVICES RENDERED 4/1/09-12/31/14 FOR SERVICES RENDERED 4/1/09-12/31/14
New York State Medicaid/State Governmental Agencies 7.04% 7.04%
Health Maintenance Organizations and PHSPs for Medicaid Patients 7.04% 7.04%
New York State Local Governments for Correctional Facility Inmates 7.04% 7.04%
Payors pursuant to the New York State Workers´ Compensation Law, Volunteer Firefighters´ Benefits Law, Ambulance Workers´ Benefit Law, and Comprehensive Motor Vehicle Insurance Reparations Act 9.63% & 28.27% 9.63%
Insurance Law Article 43 Corporations 9.63% & 28.27% 9.63%
New York State Licensed Commercial Insurers 9.63% & 28.27% 9.63%
Insurers Not Licensed in New York State 9.63% & 28.27% 9.63%
Health Maintenance Organizations and PHSPs for Non-Medicaid Patients 9.63% & 28.27%% 9.63%
Self-Insured Funds 9.63% & 28.27% 9.63%
Self-Pay Uninsured/Unspecified 9.63% N/A
Secondary Coverage - Based on Status of Primary Payor Same as Primary Same as Primary