New York State Health Care Reform Act (HCRA)

December 15, 2003

Dear Administrator/Controller:

Re: 1% Statewide Assessment Reporting for 2004

Enclosed please find the revised reporting form and instructions for hospitals to use when calculating and paying their 2004 liability to the Statewide Assessment. The form should be used by hospitals to contribute 1.00% of Net Inpatient Revenue received for discharges incurred on January 1, 2004 and thereafter.

The enclosed Statewide report form closely follows the monthly 2004 Public Goods Pool Hospital Inpatient Services Report. Providers are advised to have the Public Good Pool report on hand when completing their Statewide report.

All hospitals are reminded that a failure to timely submit reports and payments will result in Indigent Care distributions being withheld until the month following the date upon which all reporting requirements have been met.

Please be aware that all figures and calculations shown on your reporting forms are subject to audit by the New York State Department of Health and also by your independent accounting firm. Hospitals should endeavor to follow instructions closely and verify the accuracy of their calculations. The Department will be comparing reported net inpatient service revenues received for a program year with net inpatient services revenue from the institutional cost report for that same year. If large discrepancies exist, hospitals will be required to substantiate their figures.

As a result of modifications to the New York Health Care Reform Act (HCRA) enacted by Chapter 62 of the Laws of 2003, designated providers of services are required to submit reports electronically for periods on and after January 1, 2005. Providers are encouraged to submit reports electronically on a voluntary basis prior to that date. Before electronic filing can commence, the enclosed Attachment 2-W 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.

Should you have any questions concerning the foregoing or the enclosed forms, please contact Mr. Thomas Person of the Bureau of Financial Management and Information Support at (518) 474-1673.

Sincerely,

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

Enclosures