Hospital Taxes, Medicaid Supplemental Payments, and State Budgets.

IF 0.3 4区 医学 Q3 LAW
Jennifer L Herbst, Sara J O'Brien, Emily G Chumas
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引用次数: 0

Abstract

The federal Medicaid statute provides states an incentive to tax hospitals (even otherwise tax-exempt ones) as a means of raising revenue and then leverage federal matching funds by returning at least some of the tax back to the hospitals in the form of Medicaid supplemental payments. The potential for supplemental payments is attractive to hospitals, especially those struggling to recoup the costs of treating Medicaid and uninsured patients, and has resulted in political support from hospitals for states to create hospital "taxes" in name only-hospitals and states both end up with more money than they did when they started because of the federal match. When state officials begin to perceive, however, that nonprofit hospitals may be serving private rather than public interests, they are able to use these hospital taxes as a way to incrementally chip away at the historic governmental support provided through tax exemption by redirecting the revenue raised from the hospital tax to general fund purposes rather than Medicaid supplemental payments. This article looks at how states have been using hospital taxes and supplemental payments to balance state budgets and whether this practice is consistent with the Medicaid program objectives that make the taxes politically feasible.

医院税、医疗补助补助和州预算。
联邦医疗补助法案鼓励各州对医院(即使是免税的医院)征税,以此作为增加收入的一种手段,然后通过将至少部分税收以医疗补助补充支付的形式返还给医院,从而利用联邦配套基金。对医院来说,额外支付的潜力是有吸引力的,尤其是那些努力收回治疗医疗补助和未参保病人的成本的医院,这导致了医院的政治支持,让各州建立医院“税”,这只是名义上的——由于联邦政府的匹配,医院和州最终都比开始时获得了更多的钱。然而,当州政府官员开始意识到,非营利性医院可能服务于私人利益而不是公共利益时,他们就能够利用这些医院税,逐步削弱政府通过免税提供的支持,将从医院税中筹集的收入重新定向到一般基金用途,而不是医疗补助计划的补充支付。本文着眼于各州如何使用医院税和补充支付来平衡州预算,以及这种做法是否符合医疗补助计划的目标,使税收在政治上可行。
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来源期刊
CiteScore
1.10
自引率
0.00%
发文量
3
期刊介绍: The Journal of Legal Medicine is the official quarterly publication of the American College of Legal Medicine (ACLM). Incorporated in 1960, the ACLM has among its objectives the fostering and encouragement of research and study in the field of legal medicine. The Journal of Legal Medicine is internationally circulated and includes articles and commentaries on topics of interest in legal medicine, health law and policy, professional liability, hospital law, food and drug law, medical legal research and education, the history of legal medicine, and a broad range of other related topics. Book review essays, featuring leading contributions to the field, are included in each issue.
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