Dear Payor/Provider: NYS Health Care Reform Act (HCRA) Surcharges and Assessments

April 1, 2009

Dear Payor/Provider:

Re: Statutory Changes to New York Health Care Reform Act (HCRA) of 2000

This letter provides notice of statutory changes that will likely be made to the New York State Health Care Reform Act (HCRA) of 2000 as part of the enacted 2009-2010 State Fiscal Year Budget. These changes are as follows:

  • HCRA Surcharges. The surcharge percentages imposed on payments made to New York State general hospitals and diagnostic and treatment centers providing comprehensive primary care or ambulatory surgery services will be revised for services provided on or after April 1, 2009. The enclosed, entitled Indigent Care and Health Care Initiatives Surcharges by Payor, outlines the existing surcharge percentages for services rendered January 1, 2006, through March 31, 2009, and the revised surcharge percentages that will be applicable to services provided on or after April 1, 2009. For surcharge percentages applicable to services rendered prior to January 1, 2006, please visit our website at www.nyhealth.gov/regulations/hcra/index.htm.
  • Extending Covered Lives Assessment Obligations to Electing Health Insurers Licensed in States other than New York State. Effective April 1, 2009, all electing health insurers, including those licensed outside of New York State, that are authorized to write accident and health policies providing inpatient hospital coverage on an expense incurred basis, are required to pay a covered lives assessment on beneficiaries who are New York State residents. Please note that this requirement does not apply to student policies, as defined in New York State Public Health Law Section 2807-t(1)(a)(vii).

    Applicable 2009 Covered Lives Assessment rates are enclosed for your information.

Upon official enactment, a notice will be posted on our website at the above address. Necessary modifications to the electronic Public Goods Pool report will also be effectuated by the Office of Pool Administration and available on their website prior to your April 2009 submission.

If you have any questions regarding the above, please contact a HCRA representative at (518) 474-1673.

Sincerely,

John E. Ulberg, Jr.,
Director,
Division of Health Care Financing

Enclosure