Bill Text: MI SB0854 | 2009-2010 | 95th Legislature | Introduced
Bill Title: Occupations; physicians; quality assurance assessment tax on physicians; impose. Amends title of 1978 PA 368 (MCL 333.1101 - 333.25211) & adds sec. 16302.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2009-09-22 - Referred To Committee On Appropriations [SB0854 Detail]
Download: Michigan-2009-SB0854-Introduced.html
SENATE BILL No. 854
September 22, 2009, Introduced by Senator SWITALSKI and referred to the Committee on Appropriations.
A bill to amend 1978 PA 368, entitled
"Public health code,"
(MCL 333.1101 to 333.25211) by amending the title and by adding
section 16302.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
TITLE
An act to protect and promote the public health; to codify,
revise, consolidate, classify, and add to the laws relating to
public health; to provide for the prevention and control of
diseases and disabilities; to provide for the classification,
administration, regulation, financing, and maintenance of personal,
environmental, and other health services and activities; to create
or continue, and prescribe the powers and duties of, departments,
boards, commissions, councils, committees, task forces, and other
agencies; to prescribe the powers and duties of governmental
entities and officials; to regulate occupations, facilities, and
agencies affecting the public health; to regulate health
maintenance organizations and certain third party administrators
and insurers; to provide for the imposition of a regulatory fee; to
provide for the levy of taxes against certain health professionals
and health facilities or agencies; to promote the efficient and
economical delivery of health care services, to provide for the
appropriate utilization of health care facilities and services, and
to provide for the closure of hospitals or consolidation of
hospitals or services; to provide for the collection and use of
data and information; to provide for the transfer of property; to
provide certain immunity from liability; to regulate and prohibit
the sale and offering for sale of drug paraphernalia under certain
circumstances; to provide for the implementation of federal law; to
provide for penalties and remedies; to provide for sanctions for
violations of this act and local ordinances; to provide for an
appropriation and supplements; to repeal certain acts and parts of
acts; to repeal certain parts of this act; and to repeal certain
parts of this act on specific dates.
Sec. 16302. (1) The department shall assess and collect a
quality assurance assessment on physicians as provided in this
section. The quality assurance assessment on physicians is a tax
imposed on each physician and entity related to a physician that
engages in the practice of medicine or osteopathic medicine and
surgery in this state. The quality assurance assessment is imposed
at a rate of 4% of the gross revenue of the physician or entity
related to a physician. The department shall administer this
section in a manner that complies with federal requirements
necessary to assure that the quality assurance assessment qualifies
for federal matching funds. The department shall cease the
assessment and collection of the quality assurance assessment if it
is no longer eligible for federal matching funds.
(2) The quality assurance assessment collected under this
section and all federal matching funds attributed to that
assessment shall be used only for the purposes described in this
section and only as prescribed in this section. The quality
assurance assessment collected under this section and all federal
matching funds attributed to that assessment shall be used to
increase medicaid physician services reimbursement payments and to
implement, administer, and enforce this section. Only physicians
and entities related to physicians that are assessed the quality
assurance assessment under this section and that participate in the
medicaid program are eligible for increased medicaid physician
services reimbursement rates under this section.
(3) The department shall prescribe the forms and format for
use by a physician or entity related to a physician subject to the
quality assurance assessment under this section, which forms and
format are necessary to administer this section, including the
reporting of gross revenue and the calculation and collection of
the assessment. A physician or entity related to a physician
subject to the quality assurance assessment under this section
shall file an annual statement with the department on or before the
last day of the sixth month after the end of the physician's or
entity's tax year. The annual statement shall identify each
physician who provided physician services and generated revenue for
those services, along with the physician's percentage of ownership
in the entity related to a physician, if applicable. The physician
or entity shall include with the annual statement the payment of
any quality assurance assessment due under this section.
(4) A physician or entity related to a physician that
reasonably expects assessment liability under this section for the
tax year to be $2,000.00 or more shall file an estimated statement
and pay an estimated quality assurance assessment for that quarter.
For a physician or entity on a calendar year basis, the estimated
quarterly statement and payment shall be made on or before April
30, July 31, October 31, and January 31. For a physician or entity
not on a calendar year basis, the estimated statement and payment
shall be made on a quarterly basis in that physician's or entity's
fiscal year. The estimated payment made with each quarterly
statement shall be for the estimated gross revenue for the quarter
or 25% of the estimated annual assessment. The second, third, and
fourth estimated payments in the calendar or fiscal year shall
include adjustments, if necessary, to correct underpayments or
overpayments from previous quarterly payments in the calendar or
fiscal year to a revised estimate of the annual assessment.
(5) If the quality assurance assessment is imposed upon gross
revenue reported by a physician, then that gross revenue shall not
otherwise be subject to assessment under this section. If the
quality assurance assessment is imposed upon gross revenue reported
by an entity related to a physician, then that gross revenue shall
not otherwise be subject to assessment under this section.
(6) If a physician or entity related to a physician renders
physician services in this state and in another state, only the
gross revenue received for physician services provided in this
state shall be apportioned to this state and assessed as provided
under this section. If the apportionment between those gross
revenues received for physician services provided in this state and
those received in another state cannot be determined by separate
accounting methods, the department shall determine the amount of
gross revenue that is subject to assessment under this section by
multiplying the physician's or entity's total gross revenue by a
fraction, the numerator of which is the total gross revenue of the
physician or entity for providing physician services in this state
and the denominator of which is the total gross revenue of the
physician or entity for providing physician services in this state
and in any other state.
(7) In computing the amount of the quality assurance
assessment under this section, a physician or entity related to a
physician may deduct the amount of bad debts for physician services
in this state from his or her gross revenue used for the
computation of the assessment if the amount of the assessment
attributable to the bad debt had already been collected and the bad
debt amount is eligible to be claimed or could be eligible to be
claimed as a deduction pursuant to 26 USC 166.
(8) Beginning in fiscal year 2009-2010, the department shall
increase the medicaid physician services reimbursement rates for
that fiscal year. For each subsequent fiscal year in which the
quality assurance assessment for physicians is imposed and
collected, the department shall maintain the increased medicaid
physician services reimbursement rates that are financed by the
assessment. Beginning in fiscal year 2009-2010, the department
shall determine how much of the money remaining in the physician
services quality assurance assessment fund may be utilized to
offset any decline in revenue in the medicaid program and to
implement, administer, and enforce this section.
(9) The physician services quality assurance assessment fund
is created in the state treasury. The state treasurer may receive
money or other assets from any source for deposit into the fund.
The state treasurer shall direct the investment of the fund. The
state treasurer shall credit to the fund interest and earnings from
fund investments. Money in the fund at the close of the fiscal year
shall remain in the fund and shall not lapse to the general fund.
The department shall transmit all money collected under this
section and all federal matching funds attributed to that
assessment to the state treasury for deposit into the physician
services quality assurance assessment fund. The department is the
administrator of the physician services quality assurance
assessment fund for auditing purposes. The department shall
administer the fund in a manner that complies with federal
requirements necessary to assure that the quality assurance
assessment qualifies for federal matching funds.
(10) If a physician or entity related to a physician fails or
refuses to file a quarterly or annual statement or pay the
assessment imposed under this section, the department may assess
the physician or entity a penalty of 1% of the assessment for each
month that the assessment and penalty are not paid up to a maximum
of 15% of the assessment. The department may also refer for
collection to the department of treasury past due amounts
consistent with section 13 of 1941 PA 122, MCL 205.13. Each
physician who has an ownership interest in an entity related to a
physician is jointly and severally liable for filing the annual
statements, estimated quarterly statements, and all other forms and
statements required under this section; for paying the assessment
for the entity; and for any other requirement under this section.
(11) This section applies to physician services provided by an
entity related to a physician that is owned in whole or in part by
a hospital, a health maintenance organization, a nonprofit health
care corporation, or any other public or private entity.
(12) As used in this section:
(a) "Entity related to a physician" means an organization,
association, corporation, partnership, or other legal entity formed
by or on behalf of a physician or physicians to engage in the
practice of medicine or osteopathic medicine and surgery.
(b) "Gross revenue" means the amount received or receivable,
whether in cash or in kind, without deduction, from patients,
third-party payers, or any other person for physician services.
(c) "Medicaid" means that term as defined in section 22207.
(d) "Physician" means an individual licensed under this
article to engage in the practice of medicine or osteopathic
medicine and surgery.
(e) "Physician services" means health care services provided
by a physician or by a physician's assistant or nurse under the
direction, supervision, control, or delegatory authority of a
physician.
