(a) There shall be imposed on each general acute care hospital that is not an exempt facility a quality assurance fee, provided that a quality assurance fee under this article shall not be imposed on a converted hospital. (b) The quality assurance fee shall be computed starting on July 1, 2011, and continue through and including December 31, 2013. (c) Subject to Section 14169.34, upon receipt of federal approval, the following shall become operative: (1) Within 10 business days following receipt of the notice of federal approval from the federal government, the department shall send notice to each hospital subject to the quality assurance fee, and publish on its Internet Web site, the following information: (A) The date that the state received notice of federal approval. (B) The fee percentage for each subject fiscal year. (2) The notice to each hospital subject to the quality assurance fee shall also state the following: (A) The aggregate quality assurance fee after the application of the fee percentage for each subject fiscal year. (B) The aggregate quality assurance fee. (C) The amount of each payment due from the hospital with respect to the aggregate quality assurance fee. (D) The date on which each payment is due. (3) The hospitals shall pay the aggregate quality assurance fee after application of the fee percentage for all subject fiscal years in 10 installments. The department shall establish the date that each installment is due, provided that the first installment shall be due no earlier than 20 days following the department sending the notice pursuant to paragraph (1), and the installments shall be paid at least one month apart, but if possible, the installments shall be paid on a quarterly basis. (4) Notwithstanding any other provision of this section, the amount of each hospitalâs aggregate quality assurance fee after the application of the fee percentage for each subject fiscal year that has not been paid by the hospital before December 15, 2013, pursuant to paragraphs (3) and (8), shall be paid by the hospital no later than December 15, 2013. (5) (A) Notwithstanding subdivision (l) of Section 14169.31, for the purpose of determining the installments under paragraph (3), the department shall use an interim fee percentage as follows: (i) One hundred percent for subject fiscal year 2011â12 until the federal government has approved or disapproved additional capitation payments described in Section 14169.5 for that subject fiscal year. (ii) One hundred percent for subject fiscal year 2012â13 until the federal government has approved or disapproved additional capitation payments described in Section 14169.5 for that subject fiscal year. (iii) Fifty percent for subject fiscal year 2013â14 until the federal government has approved or disapproved additional capitation payments described in Section 14169.5 for that subject fiscal year. (B) The director may use a lower interim fee percentage for each subject fiscal year under this paragraph as the director, in his or her discretion, determines is reasonable in order to generate sufficient but not excessive installment payments to make the payments described in subdivision (b) of Section 14169.33. (6) The director shall determine the final fee percentage for each subject fiscal year within 15 days of the approval or disapproval, in whole or in part, by the federal government of all changes to the capitation rates of managed health care plans requested by the department to implement Section 14169.5 for that subject fiscal year, but in no event later than December 1, 2013. At the time the director determines the final fee percentage for a subject fiscal year, the director shall also determine the amount of future installment payments of the quality assurance fee for each hospital subject to the fee, if any are due. The amount of each future installment payment shall be established by the director with the objective that the total of the installment payments of the qua
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