The Oregon Administrative Rules contain OARs filed through November 15, 2015

 
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OREGON HEALTH AUTHORITY, DIVISION OF MEDICAL ASSISTANCE PROGRAMS




 

DIVISION 50
TAX RULES

410-050-0401 [Renumbered to 411-069-0000]
410-050-0411 [Renumbered to 411-069-0010]
410-050-0421 [Renumbered to 411-069-0020]
410-050-0431 [Renumbered to 411-069-0030]
410-050-0451 [Renumbered to 411-069-0040]
410-050-0461 [Renumbered to 411-069-0050]
410-050-0471 [Renumbered to 411-069-0060]
410-050-0481 [Renumbered to 411-069-0070]
410-050-0491 [Renumbered to 411-069-0080]
410-050-0501 [Renumbered to 411-069-0090]
410-050-0511 [Renumbered to 411-069-0100]
410-050-0521 [Renumbered to 411-069-0110]
410-050-0531 [Renumbered to 411-069-0120]
410-050-0541 [Renumbered to 411-069-0130]
410-050-0551 [Renumbered to 411-069-0140]
410-050-0561 [Renumbered to 411-069-0150]
410-050-0591 [Renumbered to 411-069-0160]
410-050-0601 [Renumbered to 411-069-0170]

Hospital Tax

410-050-0700
Definitions
The following definitions apply to OAR
410-050-0700 to 410-050-0870:
(1) “Authority”
means the Oregon Health Authority.
(2) "Bad Debt" means the
current period charge for actual or expected uncollectible accounts resulting from
the extension of credit on inpatient and outpatient hospital services. Bad debt
charges shall be offset by any recoveries received on accounts receivable during
that current period, subject to final assessment reporting and reconciliation processes
required in these rules.
(3) "Charges for Inpatient
Care" means gross inpatient charges generated from room, board, general nursing,
and ancillary services provided to patients, who are expected to remain in the hospital
at least overnight, and occupy a bed (as distinguished from categories of health
care items or services identified in 42 CFR 433.56(a)(2)-(19) that are not charges
for inpatient hospital services). Charges for inpatient care include all payors,
and are not limited to Medicaid patients.
(4) "Charges for Outpatient
Care" means gross outpatient charges, generated from services provided by the hospital
to a patient who is not confined overnight. These services include all ancillary
and clinic facility charges (as distinguished from categories of health care items
or services identified in 42 CFR 433.56(a)(1) and (3)-(19) that are not charges
for outpatient hospital services). Charges of outpatient care include all payors
and are not limited to Medicaid charges.
(5) "Charity Care" means
costs for providing inpatient or outpatient care services free of charge or at a
reduced charge because of the indigence or lack of health insurance of the patient
receiving the care services. Charity care results from a hospital's policy as reflected
in its official financial statements to provide inpatient or outpatient hospital
care services free of charge or at a reduced charge to individuals who meet financial
criteria. Charity care does not include any amounts above the payments by the Authority
that constitute payment in full under ORS 414.065(3), or above the payment rate
established by contract with a prepaid managed care health services organization
or health insurance entity for inpatient or outpatient care provided pursuant to
such contract, or above the payment rate established under ORS 414.743 for inpatient
or outpatient care reimbursed under that statute.
(6) "Contractual Adjustments"
means the difference between the amounts charged based on the hospital's full, established
charges and the amount received or due from the payor.
(7) "Declared Fiscal Year"
means the fiscal year declared to the Internal Revenue Service (IRS).
(8) "Deficiency" means the
amount by which the assessment, as correctly computed, exceeds the assessment, if
any, reported and paid by the hospital. If, after the original deficiency has been
assessed, subsequent information shows the correct amount of assessment to be greater
than previously determined, an additional deficiency arises.
(9) "Delinquency" means the
hospital failed to file a report when due as required under these rules or failed
to pay the assessment as correctly computed when the assessment was due.
(10) "Director" means the
Director of the Authority.
(11) "Hospital" means a hospital
with an organized medical staff, with permanent facilities that include inpatient
beds, and with medical services, including physician services and continuous nursing
services under the supervision of registered nurses, to provide diagnosis and medical
or surgical treatment primarily for, but not limited to, acutely ill patients and
accident victims, or to provide treatment for the mentally ill. Hospital, as used
in this section, does not include special inpatient care facilities as that term
is defined in ORS 442.015. For purposes of these rules, the hospital shall be identified
by using the federal payer identification number for the hospital.
(12) "Net Revenue" means
the total amount of charges for inpatient or outpatient care provided by the hospital
to patients, less charity care, bad debts, and contractual adjustments. Net revenue
does not include revenue derived from sources other than inpatient or outpatient
operations, including but not limited to, interest and guest meals and any revenue
that is taken into account in computing a long term care assessment under the long
term facility assessment.
(13) "Waivered Hospital"
means a Type A or Type B hospital as described in ORS 442.470, or a hospital that
provides only psychiatric care.
[Publications: Publications referenced
are available from the agency.]
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 33-2009, f. & cert. ef. 10-1-09;
DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0710
General Administration
(1) The purpose of these rules is to
implement the assessment imposed on hospitals in Oregon.
(2) The Authority shall administer,
enforce, and collect the hospital assessment. The Authority may assign employees,
auditors, and other agents as designated by the Director to assist in the administration,
enforcement, and collection of the assessments.
(3) The Authority may adopt
forms and reporting requirements, and change the forms and reporting requirements,
as necessary, to administer, enforce, and collect the assessments.
(4) The Authority may not
use moneys from the Hospital Quality Assurance Fund to supplant, directly or indirectly,
other moneys made available to fund services described in Section 9, Chapter 736,
Oregon Laws 2003 as amended by Section 2, Chapter 757, Oregon Laws 2005.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0720
Disclosure of Information
(1) Except as otherwise provided by
law, the Authority may not publicly divulge or disclose the amount of income, expense,
or other particulars set forth or disclosed in any report or return required in
the administration of the assessments. Particulars include but are not limited to
social security numbers, employer numbers, or other hospital identification numbers,
and any business records required to be submitted to or inspected by the Authority
or its designee to allow it to determine the amounts of any assessments, delinquencies,
deficiencies, penalties, or interest payable or paid, or otherwise administer, enforce,
or collect a health care assessment to the extent that such information shall be
exempt from disclosure under ORS 192.501(5) or other basis for exemption under Oregon's
public records law.
(2) The Authority may:
(a) Furnish any hospital,
or its authorized representative, upon request of the hospital or representative,
with a copy of the hospital's report filed with the Authority for any quarter, or
with a copy of any report filed by the hospital in connection with the report, or
with a copy of any other information the Authority considers necessary;
(b) Publish information or
statistics so classified as to prevent the identification of income or any particulars
contained in any report or return;
(c) Disclose and give access
to an officer or employee of the Authority or its designee, or to the authorized
representatives of the U.S. Department of Health and Human Services, Centers for
Medicare and Medicaid Services, the Controller General of the United States, the
Oregon Secretary of State, the Oregon Department of Justice, the Oregon Department
of Justice Medicaid Fraud Control Unit, and other employees of the state or federal
government to the extent the Authority deems disclosure or access necessary or appropriate
for the performance of official duties in the Authority's administration, enforcement,
or collection of the assessments.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0730
Entities Subject to the Hospital Assessment
Each hospital in Oregon is subject to
the hospital assessment except:
(1) Hospitals operated by
the United States Department of Veterans Affairs;
(2) Pediatric specialty hospitals
providing care to children at no charge; and
(3) Waivered hospitals, as
that term is defined in OAR 410-050-0700.
Stat. Auth.: ORS 413.042, 410.070, 411.060
Stats. Implemented: 2015
HB 2395¦ 2
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0740
The Hospital Assessment: Calculation, Report,
Due Date
(1) The amount of the assessment equals
the assessment rate multiplied by the hospital’s net revenue, consistent with
OAR 410-050-0750, 410-050-0860, and 410-050-0861. The assessment shall be imposed
on net revenues earned by the hospital on or after January 1, 2004, based on calendar
quarters. The first calendar quarter begins on January 1; the second calendar quarter
begins on April 1; the third calendar quarter begins on July 1; and the fourth calendar
quarter begins on October 1.
(2) The assessment rate shall
be determined in accordance with OAR 410-050-0860 and 410-050-0861.
(3) The hospital shall file
the quarterly report on a form approved by the Authority on or before the 75th day
following the end of the calendar quarter for which an assessment is due. The quarterly
payment is due and shall be paid at the same time required for filing the quarterly
report. The hospital shall provide all information required on the quarterly report
when due. Failure to file or pay when due shall be a delinquency.
(4) The assessment becomes
operative on July 1, 2004. The first due date for a quarterly assessment and report
shall be 75 days from September 30, which is December 13, 2004.
(5) The fiscal year reconciliation
report, including the financial statement and reconciliation statement, is due and
shall be submitted to the Authority no later than the final day of the sixth calendar
month after the hospital's declared fiscal year end. The fiscal year reconciliation
assessment payment is due and shall be paid at the same time required for filing
the fiscal year reconciliation report. The hospital shall provide all information
required on the fiscal year reconciliation report when due. Failure to file or pay
when due shall be a delinquency.
(6) Any report, statement,
or other document required to be filed under any provision of these rules must be
certified by the hospital’s chief financial officer or designee. The certification
shall attest, based on best knowledge, information, and belief, to the accuracy,
completeness, and truthfulness of the document.
(7) Payments may be made
electronically or by paper check. If the hospital pays electronically, the accompanying
report may either be faxed to the Authority at the fax number provided on the report
form or mailed to the address provided on the report form. If the hospital pays
by paper check, the accompanying report shall be mailed with the check to the address
provided on the report form.
(8) The Authority may charge
the hospital a fee of $100 if, for any reason, the check, draft, order, or electronic
funds transfer request is dishonored. This charge is in addition to any penalty
for nonpayment of the assessment that may also be due.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0750
Reporting Total Net Revenue, Use of Estimated
Revenue for Quarterly Reports
(1) A hospital shall submit quarterly
reports and quarterly payments for the calendar quarters for which an assessment
is due consistent with sections (2) and (5) of this rule, and shall submit a fiscal
year reconciliation report that includes a reconciliation statement, audited financial
statement, and any fiscal year reconciliation assessment payment based on the hospital's
declared fiscal year end consistent with sections (3) and (5) of this rule.
(2) The quarterly reports
and quarterly assessment payments shall be based on estimated net revenue, which
shall be referred to as estimated assessment. Estimated assessment is the amount
of assessment the hospital expects to owe for the current calendar quarter. The
hospital shall calculate the estimated assessment based on net revenues using the
hospital's interim financial results for the quarter for which the assessment is
due. An estimated quarterly report is due for each calendar quarter for which an
assessment is due, based on the rate of assessment applicable to that quarter. The
quarterly payment is due and shall be paid at the same time required for filing
the quarterly report.
(3) The fiscal year reconciliation
report and fiscal year reconciliation assessment payment shall be based on the amount
of assessment the hospital actually owes based on annual net revenue for all calendar
quarters for which an estimated assessment payment is due during the hospital's
declared fiscal year. The hospital shall calculate the annual net revenue for the
hospital's declared fiscal year. The fiscal year reconciliation assessment payment
due shall be the calculated assessment (using the assessment rate applicable to
the appropriate quarter, described in subsection (c) below for fiscal year reconciliation
assessment calculation purposes) on the annual net revenue reduced by the estimated
assessment payments made for each assessment quarter of the hospital's declared
fiscal year. The hospital shall provide all information required in the fiscal year
reconciliation report when due, even if no fiscal year reconciliation assessment
payment is owed:
(a) When the fiscal year
reconciliation report is submitted, it shall be accompanied by the hospital's declared
fiscal year end audited financial statement for the declared fiscal year on which
the fiscal year reconciliation report and fiscal year reconciliation assessment
payments are based;
(b) The fiscal year reconciliation
report shall include a reconciliation statement describing the relationship between
the audited financial statement and annual net revenues subject to the assessment.
The reconciliation statement may be descriptive in form and shall be consistent
with the accounting principles used in the audited financial statement;
(c) The rate applicable to
the final assessment shall be calculated as follows:
(A) If all assessment quarters
were subject to the same rate established in OAR 410-050-0160 and 410-050-0861,
then the rate applicable to the final reconciliation is the assessment rate applicable
to all such quarters. For example, if the hospital's declared fiscal year is July
1, 2004 to June 30, 2005, then the assessment rate is .93 percent of annual net
revenue;
(B) If different assessment
rates apply to calendar quarters in the hospital's declared fiscal year, the hospital
shall apply a blended rate to the total annual net revenue to determine the fiscal
year reconciliation assessment due. A blended rate is the average of the rates applicable
to all assessment quarters. The Authority shall notify the hospital of the amount
of the applicable blended rate. For example, if the hospital's declared fiscal year
overlaps two quarters assessed at a rate of .93 percent and two quarters assessed
at .50 percent, then the blended rate for purposes of the annual reconciliation
is .715 percent. For purposes of calculating the fiscal year reconciliation assessment
due, the hospital shall multiply the annual net revenue by the blended rate.
(d) If the total estimated
assessment payments already paid by the hospital for the declared fiscal year exceed
the amount of the fiscal year reconciliation assessment actually due, the fiscal
year reconciliation report shall identify the difference and the hospital shall
adjust the fiscal year reconciliation assessment due amount in the fiscal year
reconciliation report for that assessment year;
(e) The fiscal year reconciliation
report, audited financial statement, and reconciliation statement shall be due and
submitted to the Authority no later than the final day of the sixth calendar month
after the hospital's declared fiscal year end. The fiscal year reconciliation assessment
payment (if owed) is due and shall be paid at the same time required for filing
the fiscal year reconciliation report. Failure to file or pay when due shall be
a delinquency;
(f) If the declared fiscal
year end audited financial statement for the hospital is not available within the
time required in subsection (e), a fiscal year reconciliation assessment payment
(if owed) and fiscal year reconciliation report must be submitted within the time
period specified under subsection (e). The hospital may use interim financial statements
to determine the amount of the fiscal year reconciliation assessment due and may
submit a justification statement with the fiscal year reconciliation report due
no later than the date specified in subsection (e) signed by the hospital’s
chief financial officer informing the Authority when the audited financial statement
is due and certifying that an amended fiscal year reconciliation report, including
the reconciliation statement, shall be provided to the Authority within 30 days
of the hospital's receipt of the audited financial statement. Reports and payments
made after the time period required in subsection (e) shall be submitted in compliance
with OAR 401-050-0760;
(g) If the hospital does
not receive audited financial statements, then internal financial statements signed
by the hospital's chief financial officer shall be submitted where these rules otherwise
require audited financial statements;
(h) If the effective date
of the assessment is not at the start of the hospital's declared fiscal year, then
the annual net revenue for the first fiscal year reconciliation report shall be
calculated based on the number of quarters subject to the assessment versus the
total number of quarters in the hospital's declared fiscal year. For example, if
the assessment is effective on July 1, 2004 for a hospital with a declared fiscal
year ending December 31, 2004, the annual net revenues shall be calculated as follows:
total net revenues for the declared fiscal year divided by two (two of four quarters
subject to the assessment).
(4) The Authority may not
find a payment deficiency for estimated quarterly assessments as long as the hospital
paid the estimated assessments and submitted the quarterly report no later than
the quarterly due date and the estimated assessment amount was not less than the
equivalent of the assessment payment that would have been determined based on the
hospital's annual net revenue for its most recent prior declared fiscal year divided
by four and multiplied times the assessment rate for the quarter in which the actual
estimated assessment is due. Annual net revenue for purposes of section (4) of this
rule means the twelve month period in which the hospital's most recent prior declared
fiscal year occurred, regardless of whether the prior quarters were subject to an
assessment. For example, if the annual net revenue for the most recent prior declared
fiscal year was $4 million; divide that total by 4 ($1 million) and multiply the
product times the current assessment rate for the assessment quarter (.93 percent).
In this example, the estimated quarterly assessment payment may not be less than
$9,300 in order to receive the benefit of section (4) of this rule:
(a) If the hospital seeks
to use the process in section (4) of this rule, no later than the date on which
the first quarterly estimated assessment and report is due (for example, December
13, 2004, for the first assessment quarter), the hospital shall provide the Authority
with a copy of the hospital's audited financial statement for the hospital's most
recent prior declared fiscal year and identify the hospital's annual net revenue
amount for that declared fiscal year, regardless of whether any assessments were
due for that year;
(b) If the hospital does
not receive audited financial statements, then internal financial statements from
the hospital's most recent prior declared fiscal year signed by the chief financial
officer may be used for this purpose.
(5) All of the due dates
for filing reports or paying assessments are established in OAR 410-050-0740, unless
the Authority permits a later payment date. If a hospital requests an extension,
the Authority, in its sole discretion, shall determine whether to grant an extension.
There shall be a delinquency for each quarter the hospital fails to pay the estimated
assessment or file the quarterly report when due. There shall be a delinquency if
the hospital fails to pay the fiscal year reconciliation assessment or file the
fiscal year reconciliation report, including financial statements and reconciliation
statement, when due.
(6) A hospital shall declare
the date of the hospital's declared fiscal year end for purposes of establishing
final assessment reporting requirements under this rule. The declaration shall be
filed with the Authority no later than December 13, 2004, or the first date that
an estimated quarterly report and assessment is due. The hospital shall notify the
Authority within 30 days of a change to the hospital's declared fiscal year end.
A change in declared fiscal year end shall be applied to the hospital's next future
declared fiscal year for purposes of calculating the final assessment and filing
the final report.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 13-2008(Temp), f. & cert. ef.
6-12-08 thru 12-8-08; DMAP 29-2008, f. 8-29-08, cert. ef. 9-1-08; DMAP 52-2015,
f. 9-22-15, cert. ef. 10-1-15
410-050-0760
Filing an Amended Report
(1) A hospital that submits a fiscal
year reconciliation report without an audited financial statement shall submit an
amended fiscal year reconciliation report, an audited financial statement, and such
additional fiscal year reconciliation payment (if owed) for assessments and deficiencies.
The information shall be submitted within 180 days after the fiscal year reconciliation
report due date.
(2) Claim for Refund:
(a) If the amount of the
assessment in the amended fiscal year reconciliation report is less than the amount
paid by the hospital, the Authority may refund the overpayment. A refund may not
exceed the assessment amount actually paid by the hospital;
(b) The hospital shall provide
all information required on the report. No refunds shall be made prior to the Authority
receiving the hospital's audited financial statement for the declared fiscal year.
The Authority may audit the hospital, request additional information, or request
an informal conference prior to granting a refund or as part of its review;
(c) If there is an amount
due from the hospital to the Authority for any past due assessments or penalties,
any refund otherwise allowable shall first be applied to the unpaid assessments
and penalties, and the hospital notified;
(d) A hospital may not deduct
from current, prospective, or future assessment payments an amount to which it claims
to be entitled as a refund for a prior period. The claim for refund shall be made
to the Authority. .
(3) Payment of Delinquency:
(a) If the amount of the
annual assessment imposed is more than the amount paid by the hospital, the hospital
shall file an amended fiscal year reconciliation report and pay the additional fiscal
year reconciliation assessment and deficiency. The penalty under OAR 410-050-0800
shall stop accruing after the Authority receives the amended fiscal year reconciliation
report, the annual audited financial statement, and payment of the total fiscal
year reconciliation assessment and deficiency for year; except to the extent provided
in OAR 410-050-0750(4)(a);
(b) No refunds shall be made
prior to the Authority receiving the hospital audited financial statement for the
declared fiscal year. The Authority may audit the hospital, request additional information,
or request an informal conference prior to granting a refund or as part of its review;
(c) If there is an error
in the determination of the assessment due, the hospital may describe the circumstances
of the late additional payment with the filing of the amended report. The Authority,
in its sole discretion, may determine that the late additional payment does not
constitute a failure to file a report or pay an assessment giving rise to the imposition
of a penalty. In making this determination, the Authority shall consider the circumstances,
including but not limited to: nature and extent of the error; hospital explanation
of the circumstances related to the error; evidence of prior errors; and evidence
of prior penalties (including evidence of informal dispositions or settlement agreements).
This provision only applies if the hospital has filed a timely original report and
paid the assessment identified in the report.
(4) If the Authority discovers
or identifies information in the administration of these assessment rules that it
determines could give rise to the issuance of a notice of proposed action, the Authority
shall issue notification pursuant to OAR 410-050-0810.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0770
Determining the Date Filed
(1) For the purposes of these rules,
any reports, requests, appeals, payments, or other response by the hospital shall
be received by the Authority either:
(a) Before the close of business
on the date due; or
(b) If mailed, postmarked
before midnight of the due date.
(2) When the due date falls
on a Saturday, Sunday, or a legal holiday, the date filed is on the next business
day following the Saturday, Sunday, or legal holiday.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0780
Records Audit by the Authority
(1) The hospital shall maintain financial
records necessary and adequate to determine the net revenue for any calendar period
for which an assessment may be due.
(2) The Authority or its
designee may audit the hospital's records at any time for a period of five years
following the date the assessment is due to verify or determine the hospital's net
revenue.
(3) The Authority may issue
a notice of deficiency or issue a refund based upon its audit findings.
(4) Any audit, finding, or
position may be reopened if there is evidence of fraud, malfeasance, concealment,
misrepresentation of material fact, omission of income, or collusion either by the
hospital or by the hospital and a representative of the Authority.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0790
Determining Assessment for Hospital Failure
to File
(1) The law places an affirmative duty
on the hospital to file a timely and correct report.
(2) In the case of a failure
by the hospital to file a report or to maintain necessary and adequate records,
the Authority shall determine the hospital’s assessment liability according
to the best of its information and belief. Best of its information and belief means
the Authority shall use evidence available to the Authority at the time of the determination
on which a reasonable person would rely on in determining the assessment. The Authority's
determination of assessment liability shall be the basis for the assessment due
in any notice of proposed action.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0800
Financial Penalty for Failure to File a
Report or Failure to Pay Tax When Due
(1) A hospital that fails to file a
quarterly report or pay a quarterly assessment when due shall be subject to a penalty
of up to $500 per day of delinquency. The Authority, in its sole discretion, shall
determine the penalty for failure to pay the assessment or file a report. In making
this determination, the Authority shall consider evidence such as prior late payments,
prior penalties, and circumstances related to delinquency. The penalty accrues from
the date of delinquency, notwithstanding the date of any notice under these rules.
(2) A hospital that fails
to file a fiscal year reconciliation report when due is subject to a penalty of
up to $500 per day of delinquency. The Authority, in its sole discretion, shall
determine the penalty for failure to pay the assessment or file a report. In making
this determination, the Authority shall consider evidence such as prior late payments,
prior penalties, and circumstances related to delinquency. The penalty accrues from
the date of delinquency, notwithstanding the date of any notice under these rules.
(3) A hospital that files
a fiscal year reconciliation report, but fails to pay a fiscal year reconciliation
assessment when due is subject to a penalty of up to $500 per day of delinquency
up to a maximum of five percent of the amount due. The Authority, in its sole discretion,
shall determine the penalty for failure to pay the reconciliation assessment payment
or file a fiscal year reconciliation report. In making this determination, the Authority
shall consider evidence such as prior late payments, prior penalties, and circumstances
related to delinquency. The penalty accrues from the date of delinquency, notwithstanding
the date of any notice under these rules.
(4) The total amount of penalty
imposed under this section for each reporting period may not exceed five percent
of the assessment for the reporting period for which penalty is being imposed.
(5) The Authority shall collect
any penalties imposed under this section and deposit the funds in the Authority's
account established under ORS 413.101.
(6) Penalties paid under
this section are in addition to the hospital's assessment liability.
(7) If the Authority determines
that a hospital is subject to a penalty, the Authority shall issue a notice of proposed
action as described in OAR 410-050-0810.
(8) If a hospital requests
a contested case hearing pursuant to OAR 410-050-0830, the Director, at the Director's
sole discretion, may waive or reduce the amount of penalty assessed.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 33-2009, f. & cert. ef. 10-1-09;
DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0810
Notice of Proposed Action
(1) Prior to issuing a notice of proposed
action, the Authority shall notify the hospital of the potential deficiency or failure
to report that could give rise to the imposition of a penalty. The Authority shall
issue a notification letter within 30 calendar days of the report or payment due
date. The hospital shall have 30 calendar days from the date of the notice to respond.
The Authority may consider the response and any amended final report under OAR 410-050-0760
in its notice of proposed action. In all cases that the Authority has determined
that a hospital has an assessment deficiency or failure to report, the Authority
shall issue a notice of proposed action. The Authority may not issue a notice of
proposed action if the issue is resolved satisfactorily within 59 days from the
date of mailing the notification letter.
(2) The Authority shall issue
a notice of proposed action within 60 calendar days from the date of mailing the
notification letter.
(3) Contents of the notice
of proposed action shall include:
(a) The applicable reporting
period;
(b) The basis for determining
the corrected amount of assessment;
(c) The corrected assessment
due as determined by the Authority;
(d) The amount of assessment
paid by the hospital;
(e) The resulting deficiency,
which is the difference between the amount received by the Authority and the corrected
amount due as determined by the Authority;
(f) Statutory basis for the
penalty;
(g) Amount of penalty per
day of delinquency;
(h) Date upon which the penalty
began to accrue;
(i) Date the penalty stopped
accruing or circumstances under which the penalty shall stop accruing;
(j) The total penalty accrued
up to the date of the notice;
(k) Instructions for responding
to the notice; and
(l) A statement of the hospital's
right to a hearing.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 29-2008, f. 8-29-08, cert. ef. 9-1-08;
DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0820
Required Notice
(1) The Authority shall send any required
notice to the address and contact person identified by the hospital on its most
recently filed report.
(2) Any notice required to
be sent to the Authority shall be sent to the point of contact identified on the
communication from the Authority to the hospital.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0830
Hearing Process
(1) Any hospital that receives a notice
of proposed action may request a contested case hearing under ORS 183.
(2) The hospital may request
a hearing by submitting a written request within 20 days of the date of the notice
of proposed action.
(3) Prior to the hearing,
the hospital shall meet with the Authority for an informal conference:
(a) The informal conference
may be used to negotiate a written settlement agreement.
(b) If the settlement agreement
includes a reduction or waiver of penalties, the agreement shall be approved and
signed by the Director.
(4) Except as provided in
section (5) of this rule, if the case proceeds to a hearing, the administrative
law judge shall issue a proposed order. The Authority shall issue a final order.
(5) Nothing in this section
shall preclude the Authority and the hospital from agreeing to informal disposition
of the contested case at any time, consistent with ORS 183.415(5).
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0840
Final Order of Payment
A final order of payment is a final
Authority action, expressed in writing, based on a notice of proposed action where
a payment amount is due to the Authority. The Authority shall issue a final order
of payment for deficiencies or penalties when:
(1) The hospital did not
make a timely request for a hearing;
(2) Any part of the deficiency
and penalty was upheld after a hearing; or
(3) Upon the agreement of
the hospital and the Authority.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0850
Remedies Available after Final Order of
Payment
Any amounts due and owing under the
final order of payment and any interest thereon may be recovered by Oregon as a
debt to the state, using any available legal and equitable remedies. These remedies
include, but are not limited to:
(1) Collection activities
including, but not limited to, deducting the amount of the final deficiency or penalty
from any sum then or later owed to the hospital by the Authority; and
(2) Every payment obligation
owed by the hospital to the Authority under a final order of payment shall bear
interest at the statutory rate of interest in ORS 82.010 accruing from the date
of the final order of payment and continuing until the payment obligation, including
interest, has been discharged.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0860
Director Determines Assessment Rate
(1) The Director shall determine the
assessment rate.
(2) The assessment rate for
the period beginning January 1, 2004 through June 30, 2004 is 0 percent. The assessment
rate for the period beginning July 1, 2004 through December 31, 2004 is .95 percent.
(3) The Director may reduce
the rate of assessment to the maximum rate allowed under federal law if the reduction
is required to comply with federal law. If the rate is reduced pursuant to this
section, the Director shall notify the hospitals as to the effective date of the
rate reduction.
(4) A hospital is not guaranteed
that any additional moneys paid to the hospital in the form of payments for services
will equal or exceed the amount of the assessment paid by the hospital.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 91-2004(Temp), f. & cert. ef. 12-3-04
thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05; OMAP 28-2005(Temp), f.
& cert. ef. 5-10-05 thru 11-5-05; OMAP 34-2005, f. 7-8-05, cert. ef. 7-11-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0861
Assessment Rate
(1) The assessment rate for the period
beginning January 1, 2005, and ending June 30, 2006, is .68 percent.
(2) The assessment rate for
the period beginning July 1, 2006, and ending December 31, 2007, is .82 percent.
(3) The assessment rate for
the period beginning January 1, 2008, and ending June 30, 2009, is .63 percent.
(4) The assessment rate for
the period of January 1, 2008 through June 30, 2009 does not apply to the period
beginning July 1, 2009.
(5) The assessment rate for
the period beginning July 1, 2009, and ending September 30, 2009, is .15 percent.
(6) The assessment rate for
the period beginning October 1, 2009, and ending June 30, 2010, is 2.8 percent.
(7) The assessment rate for
the period beginning July 1, 2010, and ending June 30, 2011, is 2.32 percent.
(8) The assessment rate for
the period beginning July 1, 2011, and ending September 30, 2011, is 5.25 percent.
(9) The assessment rate for
the period beginning October 1, 2011, and ending December 31, 2011, is 5.08 percent.
(10) The assessment rate
for the period beginning January 1, 2012, and ending March 31, 2013, is 4.32 percent.
(11) The assessment rate
for the period beginning April 1, 2013 and ending September 30, 2014, is 5.30 percent.
(12) The assessment rate
for the period beginning October 1, 2014, is 5.80 percent.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 28-2005(Temp),
f. & cert. ef. 5-10-05 thru 11-5-05; OMAP 34-2005, f. 7-8-05, cert. ef. 7-11-05;
OMAP 14-2006, f. 6-1-06, cert. ef. 7-1-06; DMAP 29-2007, f. 12-31-07, cert. ef.
1-1-08; DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 24-2009, f. & cert. ef.
7-1-09; DMAP 25-2009(Temp), f. & cert. ef. 7-15-09 thru 1-10-10; DMAP 27-2009,
f. & cert. ef. 9-1-09; DMAP 33-2009, f. & cert. ef. 10-1-09; DMAP 21-2010,
f. 6-30-10, cert. ef. 7-1-10; DMAP 16-2011(Temp), f. & cert. ef. 7-1-11
thru 11-1-11; DMAP 26- 2011(Temp), f. 9-29-11, cert. ef. 10-1-11 thru 11-1-11; DMAP
31-2011, f. 10-28-11, cert. ef. 11-1-11; DMAP 50-2011(Temp), f. 12-30-11, cert.
ef. 1-1-12 thru 4-30-12; DMAP 8-2012, f. 2-27-12, cert. ef. 3-1-12; DMAP 15-2013(Temp),
f. & cert. ef. 4-1-13 thru 9-27-13; DMAP 41-2013, f. & cert. ef. 8-1-13;
DMAP 58-2014(Temp), f. & cert. ef. 10-1-14 thru 3-29-15; DMAP 68-2014, f. &
cert. ef. 12-1-14; DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15
410-050-0870
Sunset Provisions
The hospital assessment applies to net
revenue received by hospitals on or after January 1, 2004 and before October 1,
2019.
Stat. Auth.: ORS 413.042
Stats. Implemented: 2015
HB 2395
Hist.: OMAP 86-2004(Temp),
f. & cert. ef. 11-9-04 thru 5-7-05; OMAP 25-2005, f. 4-15-05, cert. ef. 5-7-05;
DMAP 3-2008, f. & cert. ef. 1-25-08; DMAP 33-2009, f. & cert. ef. 10-1-09;
DMAP 53-2013(Temp), f. & cert. ef. 10-1-13 thru 3-29-14; DAMP 17-2014, f. &
cert. ef. 3-25-14; DMAP 52-2015, f. 9-22-15, cert. ef. 10-1-15

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