AMENDED BY ACT 2026-391, EFFECTIVE OCTOBER 1, 2026. SEE ACT FOR REVISED LANGUAGE. (a)(1) There is created within the Health Care Trust Fund referenced in Article 3 of Chapter 6 of Title 22 a designated account known as the Hospital Assessment Account. (2) The hospital assessments imposed under this article shall be deposited into the Hospital Assessment Account. (b) Monies in the Hospital Assessment Account shall consist of: (1) All monies collected or received by the department from privately operated hospital assessments imposed under this article; (2) Any interest or penalties levied in conjunction with the administration of this article; and (3) Any appropriations, transfers, donations, gifts, or monies from other sources, as applicable. (c) The Hospital Assessment Account shall be separate and distinct from the State General Fund and shall be supplementary to the Health Care Trust Fund. (d) Monies in the Hospital Assessment Account shall not be used to replace other general revenues appropriated and funded by the Legislature or other revenues used to support Medicaid. (e) The Hospital Assessment Account shall be exempt from budgetary cuts, reductions, or eliminations caused by a deficiency of State General Fund revenues to the extent permissible under Section 213 of the Constitution of Alabama of 2022. (f)(1) Except as necessary to reimburse any funds borrowed to supplement funds in the Hospital Assessment Account, the monies in the Hospital Assessment Account shall be used only as follows: a. To make public, private, and state inpatient and outpatient hospital payments. b. To reimburse monies collected by the department from hospitals through error or mistake or under this article. (2)a. The Hospital Assessment Account shall retain account balances remaining each fiscal year. b. On September 30, 2014, and each year thereafter, any positive balance remaining in the Hospital Assessment Account which was not used by the Medicaid Agency to obtain federal matching funds and paid out for hospital payments, shall be factored into the calculation of any new assessment rate by reducing the amount of hospital assessment funds that must be generated during the next fiscal year. The Medicaid Agency may carry over a balance of unspent assessment funds not considered in the previous sentence and not to exceed one-third of the total current year’s assessment, through fiscal year 2028 to account for future variations in hospital expenses and federal match rates in the upcoming fiscal year. If there is no new assessment beginning October 1, 2028, the funds remaining shall be refunded to the hospital that paid the assessment or made an intergovernmental transfer in proportion to the amount remaining. (3) A privately operated hospital shall not be guaranteed that its inpatient and outpatient hospital payments will equal or exceed the amount of its hospital assessment.
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