New York State Health Care Reform Act (HCRA)

July 1, 2003

Dear Administrator/Comptroller:

Re: Revised Public Goods Pool Reporting Forms for Hospitals

Enclosed please find revised reporting forms and instructions for designated providers to use when calculating and remitting payments to the Public Goods Pools. The documents have been revised to reflect modifications to the New York Health Care Reform Act (HCRA) enacted by Chapter 62 of the Laws of 2003.

The modifications change the surcharges assessed on affected net patient service revenue for services performed on or after July 1, 2003. The regionally varying Professional Education Pool surcharge applicable, in addition to the patient services surcharge, to inpatient hospital payments made by affected non-electing payors has also increased for dates of service July 1, 2003 through June 30, 2005. The statute also requires designated providers of services to submit reports electronically for periods on and after January 1, 2005. Providers are encouraged to submit reports electronically on a voluntarily basis prior to that date. Before electronic filing can commence, the enclosed Attachment 2-WP must be completed to obtain a secure user ID and password. If you have any questions concerning electronic filing, please contact the electronic filing help desk at (315) 671-3800 or via e-mail at webpools@hcrapools.org.

Providers are required to file the Provider Certification Form, Payment Summary, and the two most recent service year portions of the Report of Patient Services Revenue and Surcharge Obligations monthly, even if there is no activity to report. Prior service year portions of the report are required only when a provider has net patient services revenue and/or prior period adjustments to report which relate to those service years. Revenue received during the month for surchargeable claims for services rendered during a prior service year must be reported on the appropriate service year´s form. Additionally, adjustments necessary to information previously reported for such service years must be reported as prior period adjustments on the appropriate service year's form. The report forms are also available on the WEB at: www.health.ny.gov/regulations/hcra/rfmenu.htm

Reports must be completed and submitted in accordance with the enclosed instructions. If, upon review, a report is deemed unacceptable, the report may be returned and a delinquency notice issued. Failure to comply with the reporting provisions provided in Sections 2807-j and 2807-s of the Public Health Law (PHL) may result in the recoupment of the facility´s estimated monthly assessment liability, along with interest and/or penalty, from various third party payments pursuant to Section 2807-j(6) of the Public Health Law. Additionally, PHL Section 2807-j(7)(c) authorizes the Commissioner to assess civil penalties for certain reporting delinquencies.

Should you have any questions concerning the foregoing or the enclosed forms, please contact a HCRA representative at (518) 474-1673.

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

Enclosures