N.J. Admin. Code § 10:52B-3.3

Current through Register Vol. 56, No. 24, December 18, 2024

Section 10:52B-3.3 - Permissible use of funds

(a) A participating county shall use funds collected from the imposition of a fee as follows:

1. The participating county shall use at least 90 percent of the fee proceeds for the benefit of hospitals located in the county, as follows:

i. The participating county shall make an intergovernmental transfer (IGT) of the funds under an intergovernmental agreement (IGA) with the Department authorizing the Department's use of the funds as the non-Federal share of Medicaid/NJ FamilyCare payments to the local hospitals; or

ii. The participating county may retain the funds and use the funds to make payments to local hospitals as authorized in its approved fee and expenditure report. However, the Commissioner shall only approve a participating county's proposal to retain funds collected from the imposition of a fee provided that the participating county demonstrates, to the satisfaction of the Commissioner, that the county has sufficient funds to make payments to local hospitals in the amount of the fee proceeds that would otherwise have been transferred to the Department, plus an amount equal to the Federal matching funds that would have been paid to the Department had the fee proceeds been used as the non-Federal share Medicaid/NJ FamilyCare payments;

2. A participating county may retain no more than nine percent of the proceeds for its own use;

3. The county shall transfer at least one percent of assessment proceeds to the Department for the cost of administering the program. Should the State's administrative costs for the program exceed the total value of funding transferred by the participating counties for this purpose, remaining costs shall be subtracted from amounts otherwise available as the non-Federal share of payments to hospitals in the participating counties; and

4. Unless the county has received approval to retain funds pursuant to (a)1ii above, the county shall transfer all funds to the State on a quarterly basis, not later than 15 days after the close of each quarter of the State fiscal year. Failure to transfer the funds within this timeframe shall result in penalties imposed by the Department that may include interest penalties of up to 1.5 percent of the outstanding transfer amount per month and/or removal from the pilot program.

(b) The Department shall use the fee proceeds transferred from a participating county, and any Federal matching funds or other Federal funds generated therefrom, for the following purposes, the Department may:

1. Increase Medicaid/NJ FamilyCare payments to hospitals located in the participating county;

2. Make payments to Medicaid/NJ FamilyCare managed care organizations operating in the participating county for increased hospital or hospital-related payments; and/or

3. Use the funds for costs directly related to the administration of the pilot program.

(c) The Department shall not use the transferred fee proceeds to supplant or offset any current or future State funds allocated to a participating county, except that payments may be otherwise limited to the hospital's hospital-specific disproportionate share (DSH) limit as provided in Section 1923(g) of the Social Security Act ( 42 U.S.C § 1394r-4).

(d) All hospitals shall maintain records regarding expenditure of funds and make such records available to the Department, the Department's designated representative, or other authorized agent, upon request.

N.J. Admin. Code § 10:52B-3.3

Adopted by 52 N.J.R. 520(a), effective 3/16/2020