Bill
HB 2250
Kansas HB 2250 raises hospital assessments to up to 6.0% of net inpatient/outpatient revenue and adds CAHs and REHs above thresholds, boosting Medicaid funding pending CMS OK.
Status snapshot
- Introduced: January 30, 2025
- Committee hearing (per packet): Wednesday, March 5, 2025, 1:30 PM, Room 112‑N
- Jurisdiction: Materials in the packet appear primarily to relate to Kansas statute amendments (K.S.A. 65‑6208 et seq.). Note: the packet also includes unrelated HB 2250 texts from other states (Arizona, Illinois); this summary focuses on the Kansas measure increasing hospital assessments. Verify the state context before taking action.
Purpose / intent
- To raise and broaden the statutory hospital provider assessment used to generate state and federal Medicaid financing, by (1) increasing the maximum assessment rate and (2) expanding the base of hospitals subject to the assessment.
Key provisions
- Assessment rate:
- Changes the statutory range so the assessment may be set up to 6.0% (previous statutory cap references show up to 3.0%). The stated assessment basis becomes 6.0% of each hospital’s net inpatient and outpatient operating revenue (measured for the hospital fiscal year three years prior to the assessment year).
- The statute retains a lower bound (referenced historically as not less than 1.83% on inpatient revenues) but allows the panel to determine the specific rate within statutory limits.
- Expanded base:
- Adds critical access hospitals (CAHs) and rural emergency hospitals (REHs) with revenues above a threshold (threshold to be set by the Healthcare Access Improvement Panel) to the list of assessed providers.
- Certain entities remain exempt (state agencies, authorities, state educational institutions, CAHs/REHs with revenues below panel‑determined thresholds, and certain hospitals operated for mental health/developmental disabilities).
- Administration, collection, penalties:
- The Healthcare Access Improvement Panel, in consultation with KDHE, determines revenue measures and thresholds.
- KDHE authorized to submit required approval requests to CMS (Centers for Medicare & Medicaid Services) to implement changes and must publish certification of CMS approval.
- Payment timing: installments mechanism retained; language in the bill adjusts installment due dates and ties first payments to CMS approval and to hospitals’ receipt of payments for 150 days after the effective date of the approved payment methodology.
- KDHE may establish delayed payment schedules for hospitals with financial difficulty.
- Penalties for nonpayment: added penalty assessment up to lesser of (a) 5% of unpaid installment plus 5% monthly on remaining unpaid balance, or (b) 100% of the unpaid installment; departments may take legal action on recommendation of the panel. Payments are credited first to unpaid installments rather than to penalty or interest amounts.
- Repeals and effective date:
- The bill repeals the existing sections being amended. The effective date of the assessment changes is tied to CMS approval of the state plan/payment methodology; the statute contemplates an effective date of January 1 or July 1 following CMS approval/publication.
Fiscal impact
- Fiscal note (Kansas Division of the Budget, 2/20/2025): KDHE reports no fiscal effect to the agency from enactment because the bill implements practices already in place via budget provisos. The fiscal note does not provide an estimate of statewide fiscal impact (revenues or Medicaid match), but increasing assessment rates and widening the base would be expected to increase state assessment receipts and likely increase federal Medicaid drawdown if CMS approves the mechanism.
Who is affected
- Primary: Kansas hospital providers (all acute care hospitals whose net inpatient/outpatient revenues exceed thresholds set by the panel), including potentially CAHs and REHs that cross the revenue threshold.
- KDHE and the Healthcare Access Improvement Panel (administration, CMS coordination).
- Potentially state Medicaid program finances (revenues and payments), and hospitals’ cash flows due to higher assessment obligations (mitigated by payment schedules or department delays).
Procedural / timeline notes
- CMS approval required: assessment changes take effect only after KDHE submits and obtains CMS approval of the payment methodology/state plan amendment; the act ties the effective date to that approval/publication.
- The bill (per packet) was scheduled for committee hearing March 5, 2025 and has subsequently proceeded through readings and committee referrals; confirm current status with the legislative clerk for up‑to‑date action.
Note on packet inconsistencies
- The source packet contains other unrelated HB 2250 texts (Arizona and Illinois versions) and a sponsor name (Rep. Tony M. McCombie) associated with Illinois. Those are not part of the Kansas statutory amendments described above. Confirm the correct jurisdiction and bill sponsor before relying on this summary for legislative action.
Compiled from official sources — confirm details with the bill’s official record.
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