N.J.S.A. 26:2H-18.60g — Recovery for fraudulent claim.

26:2H-18.60g Recovery for fraudulent claim. 8. If a charity care claim is determined to be fraudulent, a hospital shall be entitled to recover from the patient the difference between the amount of the charity care claim and the amount that the patient would have otherwise been charged by the hospital to provide the health care services for which the charity care claim was filed. L.2007,c.217,s.8. 26:2H-18.61. Distribution of monies for other uncompensated care 11. a. The monies in the other uncompensated care component of the disproportionate share hospital subsidy account shall be distributed to eligible hospitals in accordance with the formulas provided in subsections b. and c. of this section. In 1993, the fund shall distribute $100 million in subsidies to eligible hospitals; in 1994, the fund shall distribute $67 million to eligible hospitals; and in 1995, the fund shall distribute $33 million to eligible hospitals. Such funds as may be necessary shall be transferred by the department from the fund to the Division of Medical Assistance and Health Services in the Department of Human Services for payment to disproportionate share hospitals. b. The determination of whether a hospital is eligible to receive a subsidy shall be based on the following: Hospital Specific Other Uncompensated Care for Year ................................................................... Hospital Specific Revenue for Year = Hospital Specific % Other Uncompensated Care (%OUC) A hospital is eligible for a subsidy if, upon establishing a rank order of the %OUC for all hospitals: (1) in 1993, the hospital is among the 45% of hospitals with the highest %OUC; (2) in 1994, the hospital is among the 30% of hospitals with the highest %OUC; and (3) in 1995, the hospital is among the 15% of hospitals with the highest %OUC. c. The amount of the subsidy an eligible hospital shall receive shall be based on the following: Hospital Specific Other Uncompensated Care for Year ............................................................ Total Other Uncompensated Care for All Eligible Hospitals for Year X Total Amount of Subsidy Allocated for the Year = Hospital Specific Subsidy for the Year In 1993, the formulas shall use 1991 Hospital Specific Other Uncompensated Care and Total Other Uncompensated Care for All Eligible Hospitals, and a hospital's 1992 preliminary cost base established pursuant to section 18 of P.L.1971, c.136 (C.26:2H-18), for "Hospital Specific Revenue for Year." In 1994 and through the payment for April of 1995, the formulas shall use 1992 Hospital Specific Other Uncompensated Care and Total Other Uncompensated Care for All Eligible Hospitals, and a hospital's 1993 revenue cap established pursuant to section 3 of this act for "Hospital Specific Revenue for Year." Payments made under these formulas for February, March and April of 1995 shall, as of May 1, 1995, be final payments and shall not be subject to any reconciliation or other adjustment. Beginning with the payment for May of 1995, the formulas shall use actual 1993 Medicare revenues, as approved by the department, in place of "Hospital Specific Other Uncompensated Care for Year" and "Total Other Uncompensated Care for All Eligible Hospitals for Year," and a hospital's 1993 total operating revenue as defined by the department in accordance with financial reporting requirements established pursuant to N.J.A.C.8:31B-3.3, in place of "Hospital Specific Revenue for Year." d. The department shall notify the Division of Medical Assistance and Health Services of the amount of Other Uncompensated Care hospital subsidy payment to be included in the disproportionate share payment to each eligible hospital. L.1992,c.160,s.11; amended 1995,c.133,s.7.

This is the verbatim text of N.J.S.A. 26:2H-18.60g, retrieved from the New Jersey Legislature's public statute corpus. Statutes are amended periodically — for the most current version, check the external source link above. Kyzer is not a law firm and this page is not legal advice.