§ 2807-k. General hospital indigent care pool. 1. Definitions. For\npurposes of this section, the following words or phrases shall have the\nfollowing meanings, unless the context otherwise requires:\n (a) "Major public general hospital" means all state operated general\nhospitals, all general hospitals operated by the New York city health\nand hospitals corporation as established by chapter one thousand sixteen\nof the laws of nineteen hundred sixty-nine as amended and all other\npublic general hospitals having annual inpatient operating costs in\nexcess of twenty-five million dollars.\n (b) "Nominal payment amount" shall mean the sum of the dollars\nattributable to the application of an incrementally increasing\nproportion of reimbursement for percentage increases in targeted need\naccording to a scale.\n (c) "Targeted need" shall mean the relationship of uncompensated care\nneed to reported costs expressed as a percentage. Reported costs shall\nmean costs allocated as prescribed by the commissioner to general\nhospital inpatient and ambulatory services, excluding referred\nambulatory services. Targeted need shall be determined based on base\nyear data and statistics for the calendar year two years prior to the\ndistribution period. Base year data and statistics for the calendar year\ntwo years prior to the distribution period shall be considered final,\nfor purposes of this section, one hundred twenty days after hospitals\nreceive the department's initial statewide rates for the same period as\nthe distribution period and shall include any appropriate revisions\nreported by hospitals during such one hundred twenty days.\n (d) "Uncompensated care need" means losses from bad debts reduced to\ncost and the costs of charity care of a general hospital for inpatient\nand ambulatory services, excluding referred ambulatory services. The\ncost of services provided as an employment benefit or as a courtesy\nshall not be included.\n (e) "Uninsured care" means losses from bad debts reduced to cost and\nthe costs of charity care of a general hospital for inpatient and\nambulatory services, excluding referred ambulatory services, which are\nnot eligible for payment in whole or in part by a governmental agency,\ninsurer or other third-party payor on behalf of a patient, including\npayments made directly to the general hospital and indemnity or similar\npayments made to the person who is a payor of hospital services. The\ncost of services denied reimbursement, other than emergency room\nservices, for lack of medical necessity or lack of compliance with prior\nauthorization requirements, or provided as an employment benefit, or as\na courtesy shall not be included.\n (f) "Ambulatory services" of a general hospital shall mean all\nservices delivered on an ambulatory basis, including, for periods on and\nafter January first, two thousand four, services provided at qualified\nhospital-controlled diagnostic and treatment centers except as otherwise\nprovided in subdivision thirteen of this section.\n (g) "Qualified hospital-controlled diagnostic and treatment center"\nshall mean a voluntary, non-profit diagnostic and treatment center\nproviding a comprehensive range of primary health care services that is\ncontrolling, controlled by, or under common control with a general\nhospital, and as of June thirtieth, two thousand three:\n (i) qualified for an allocation of funds pursuant to section\ntwenty-eight hundred seven-p of this article or pursuant to section\nseven of chapter four hundred thirty-three of the laws of nineteen\nhundred ninety-seven, as amended; or\n (ii) the outpatient department of such general hospital had been\ndesignated a federally-qualified health center under section 330 of the\nPublic Health Service Act (42 U.S.C. § 254b) and had directly received a\ngrant under such section.\n (h) "Underinsured" shall mean an individual with out of pocket medical\ncosts accumulated in the past twelve months that amount to more t
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