§346G-5  Hospital sustainability fee.  [See Note at chapter heading.]  (a)  Effective July 1, 2012, or, if later, the effective date of any necessary federal approvals, the department shall charge and collect  provider fees, to be known as the hospital sustainability fee, on inpatient and outpatient care services provided by private hospitals.

     (b)  The hospital sustainability fee shall be based on the net patient service revenue for inpatient services and outpatient services, respectively, of all hospitals that are subject to the hospital sustainability fee.

     (c)  The hospital sustainability fee for inpatient care services may differ from the fee for outpatient care services but the fees charged to the hospital shall not in the aggregate exceed five and one-half per cent of the hospital's net patient service revenue.  The inpatient hospital sustainability fee shall not exceed five and one-half per cent of net inpatient hospital service revenue.  The outpatient hospital sustainability fee shall not exceed five and one-half per cent of net outpatient hospital service revenue.  Each fee shall be the same percentage for all affected hospitals, subject to subsection (d).

     (d)  The department shall exempt federal hospitals and public hospitals from the hospital sustainability fees on inpatient services and outpatient care services.

     Children's hospitals, psychiatric hospitals, and rehabilitation hospitals may be assessed hospital sustainability fees on inpatient and outpatient services at a different rate than other private hospitals.  The department may also exclude any facility from the hospital sustainability fee if it is determined that its exclusion is required to meet federal standards of approval.

     (e)  The department, with agreement by the hospital trade association located in Hawaii, may modify the structure of the hospital sustainability program if such modification is necessary to obtain federal waiver approval consistent with the requirements of 42 Code of Federal Regulations section 433.68(e)(2).

     (f)  Notwithstanding section 346G-6, nothing shall require the department to exempt a facility from the hospital sustainability fee if it is not approved by the United States Department of Health and Human Services Centers for Medicare and Medicaid Services. [L 2012, c 217, pt of §2, §5; am L 2013, c 141, pt of §1, §2; am L 2014, c 123, §§1(2), 2; am L 2015, c 70, §§1(3), 2; am L 2016, c 60, §§2(3), 3; am L 2017, c 59, §§3, 5; am L 2019, c 173, §§3, 6; am L 2021, c 38, §3]