SECOND REGULAR SESSION
93RD GENERAL ASSEMBLY
INTRODUCED BY REPRESENTATIVES CORCORAN (Sponsor), ZWEIFEL, GEORGE, HENKE, ROORDA, YOUNG, FRASER, HARRIS (110), DARROUGH, SCHOEMEHL, DONNELLY, KUESSNER, OXFORD, BOWMAN, DOUGHERTY, LOWE (44), SPRENG, BROWN (50), WALSH, VOGT, YAEGER, BURNETT, MEADOWS, LIESE, WAGNER, CHAPPELLE NADAL, JOHNSON (90), LeVOTA, BOGETTO, ROBINSON, MEINERS, WILDBERGER, DAUS, LOW (39) AND SALVA (Co-sponsors).
Read 1st time February 16, 2006 and copies ordered printed.
STEPHEN S. DAVIS, Chief Clerk
AN ACT
To amend chapter 285, RSMo, by adding thereto six new sections relating to health care payroll assessments.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Chapter 285, RSMo, is amended by adding thereto six new sections, to be known as sections 285.400, 285.403, 285.406, 285.409, 285.412, and 285.415, to read as follows:
285.400. As used in sections 285.400 to 285.415, the following terms shall mean:
(1) "Department", the department of social services;
(2) "Director", the director of the department of social services;
(3) "Employee", all individuals employed full-time or part-time directly by an employer;
(4) "Employer", the same meaning as such term is defined in section 287.030, RSMo; except that, employer shall not include the federal government, the state of Missouri, any other state, or any political subdivision of this state or another state. The provisions of sections 285.400 to 285.415 shall apply to any employer with seven thousand five hundred or more employees in this state;
(5) "Health insurance costs", the amount paid by an employer to provide health care or health insurance to employees in this state to the extent such costs may be deductible by an employer under federal tax laws and shall include payments for medical care, prescription drugs, vision care, medical savings accounts, and any other costs to provide health benefits as defined in Section 231(d) of the Internal Revenue Code of 1986, as amended.
285.403. 1. Beginning January 1, 2007, there is hereby established a program within the department of social services to supplement the state Medicaid program by providing reimbursement to health care providers for the provision of uncompensated medical treatment under the state Medicaid program. The department of social services, in consultation with the departments of insurance and labor and industrial relations, shall administer the program and promulgate rules for the implementation of the program.
2. Beginning February 1, 2007, and each February first thereafter, each employer subject to sections 285.400 to 285.412 shall annually submit on a form in a manner approved by the director:
(1) The number of employees of the employer in this state for the immediately preceding calendar year;
(2) The amount spent by the employer in the immediately preceding calendar year on employer-sponsored health care benefits for employees in this state;
(3) The number of employees of the employer in this state whose primary health care benefits are provided by Medicare; and
(4) Any other information deemed necessary by the director to determine an employer's obligation under the program, if any.
3. Any information required to be submitted under subsection 2 of this section shall:
(1) Be provided in a report signed by the employer's principal executive officer or an individual performing a similar function for the employer; and
(2) Include an affidavit under penalty of perjury that the information required under subsection 4 of this section was reviewed by the signing officer and is true to the best of the signing officer's knowledge, information, and belief.
4. The department shall exclude any employer-sponsored health care benefits provided to an employee as secondary coverage to the employee's Medicare benefits when determining whether an employer shall be subject to a surcharge under the program.
5. Beginning March 1, 2007, and each March first thereafter, the department of insurance, in collaboration with the departments of social services and labor and industrial relations, shall determine the annual state average cost of employer-sponsored health care benefits per employee in this state for the immediately preceding calendar year. Upon such determination, the department of social services shall utilize the annual state average cost of employer-sponsored health care benefits per employee in this state provided by the department of insurance to calculate the surcharge to be imposed on employers which spend less than such amount on employer-sponsored health care benefits for its employees. Beginning May 1, 2007, and each May first thereafter, each employer subject to the provisions of this section shall be notified of the amount of surcharge to be imposed for the next fiscal year beginning July first.
6. Beginning July 1, 2007, every employer in this state with seven thousand five hundred employees or more in this state shall be subject to a surcharge based on an amount equal to the state average cost of employer-sponsored health care benefits per employee in this state minus the amount the employer actually spends per employee in this state on employer-sponsored health care benefits. Any employer subject to the provisions of this section which exceeds the state average shall not be subject to a surcharge. The surcharge imposed under this section shall be imposed on a July first to June thirtieth fiscal year basis.
285.406. 1. An employer that is organized as a nonprofit organization that does not spend a total amount on health insurance benefits for its employees in this state that is equal to or greater than the state average of all employer-sponsored health insurance costs per employee multiplied by the number of employees of the nonprofit organization employer in this state shall pay to the director an amount equal to the difference between the amount the nonprofit organization employer actually spends for health insurance costs and an amount equal to the state average of all employer-sponsored health insurance costs per employee multiplied by the number of employees of the nonprofit organization in this state.
2. An employer that is not organized as a nonprofit organization and that does not spend a total amount on health insurance benefits for its employees in this state that is equal to or greater than the state average of all employer-sponsored health insurance costs per employee plus two percent multiplied by the number of employees of the employer in this state shall pay to the director an amount equal to the difference between the amount the for-profit employer spends for health insurance costs and an amount equal to the state average of all employer-sponsored health insurance costs per employee plus two percent multiplied by the number of employees of the for-profit employer in this state.
3. No employer shall deduct any payment made under subsection 1 or 2 of this section from the wages of an employee.
4. An employer shall make the payments required under this section to the director on a periodic basis as determined by the director.
285.409. 1. Any employer that fails to report in accordance with sections 285.400 to 285.415 shall be subject to an administrative penalty of two hundred fifty dollars for each day that the report is not timely filed.
2. Any employer that fails to make a payment required under sections 285.400 to 285.415 shall be liable for any unpaid surcharge amounts plus an administrative penalty of up to ten percent of the unpaid balance, to be determined by the director.
3. Any moneys collected under this section for nonpayment of the surcharge shall be deposited in the uncompensated care fund established under section 285.415.
4. The attorney general shall enforce the provisions of this section.
285.412. 1. As used in this section, "health insurance benefits" includes payments for medical care, prescription drugs, vision care, medical savings accounts, and any other costs to provide health benefits as defined in Section 213(d) of the Internal Revenue Code of 1986, as amended.
2. On or before March fifteenth of each year, the director shall report to the governor and the general assembly on:
(1) The name of each nonprofit and for-profit employer with seven thousand five hundred or more employees in this state;
(2) The employer's definition of full-time employee and part-time employee;
(3) The number of full-time employees;
(4) The number of full-time employees eligible to receive health insurance benefits from the employer;
(5) The number of full-time employees receiving health insurance benefits from the employer;
(6) The source of health insurance benefits for those eligible full-time employees not receiving health insurance benefits through an employer subject to reporting under sections 285.400 to 285.415, if known by the employer;
(7) The number of part-time employees;
(8) The number of part-time employees eligible to receive health insurance benefits from the employer;
(9) The number of part-time employees receiving health insurance benefits from the employer; and
(10) The source of health insurance benefits for those eligible part-time employees not receiving health insurance benefits through an employer subject to reporting under sections 285.400 to 285.415, if known by the employer.
3. The information required under subsection 2 of this section shall be reported as of the information reporting date determined by the employer under subdivision (1) of subsection 1 of section 285.403. Such information shall be confidential and shall not be subject to the provisions of chapter 610, RSMo.
285.415. 1. The director shall:
(1) On an annual basis and based on the information reported under subdivision (1) of subsection 1 of section 285.403:
(a) Verify which employers have seven thousand five hundred or more employees in this state; and
(b) Ensure that all employers with seven thousand five hundred or more employees in this state make the report required under section 285.403;
(2) Promulgate rules to implement the provisions of sections 285.400 to 285.415; and
(3) Transfer any moneys collected from the payroll assessment into the uncompensated care fund established in subsection 2 of this section.
2. (1) There is hereby created in the state treasury the "Uncompensated Care Fund" which shall consist of moneys collected under sections 285.400 to 285.415. The state treasurer shall be custodian of the fund and shall disburse moneys from the fund in accordance with sections 30.170 and 30.180, RSMo. Upon appropriation, money in the fund shall be used solely to reimburse licensed hospitals and federally qualified health centers that provide uncompensated care to patients as state Medicaid providers.
(2) Notwithstanding the provisions of section 33.080, RSMo, to the contrary, any moneys remaining in the fund at the end of the biennium shall not revert to the credit of the general revenue fund.
(3) The state treasurer shall invest moneys in the fund in the same manner as other funds are invested. Any interest and moneys earned on such investments shall be credited to the fund.
3. The division of medical services within the department of social services shall establish by rule a formula of reimbursement from the uncompensated care fund on a prorated basis for Medicaid providers that provide uncompensated care to patients under the state Medicaid program. Any moneys distributed under the program from the fund shall be in addition to and not in lieu of any required Medicaid reimbursement payments to providers under the state Medicaid program.
4. Any rule or portion of a rule, as that term is defined in section 536.010, RSMo, that is created under the authority delegated in sections 285.400 to 285.415 shall become effective only if it complies with and is subject to all of the provisions of chapter 536, RSMo, and, if applicable, section 536.028, RSMo. Sections 285.400 to 285.415 and chapter 536, RSMo, are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536, RSMo, to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2006, shall be invalid and void.
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