2023 Quarterly Provider Tax Reports - Quarter 3

PROVIDER-RELATED DONATIONS AND
HEALTH CARE RELATED TAXES, FEES AND ASSESSMENTS RECEIVED UNDER PUBLIC HEALTH LAW 102-334 BY

New York State Department of Health
(Print or type name of agency)

FOR THE QUARTER ENDED

DECEMBER 31, 2023
CODE NAME OF TAX/ASSESSMENT PROGRAM ST. CITE PROVIDER/SERVICE CLASS (42 CFR) AMOUNT
1 Bad Debt and Charity Care and Capital Statewide Pool Assessment PHL 2807-c(18) Inpatient Hospital Services 131,292,596.00
1 Bad Debt and Charity Care Regional Allowance PHL 2807-c(14) & (16) Inpatient Hospital Services 0.00
1 Patient Services Payments PHL 2807-j Inpatient Hospital Services 609,796,510.05
1 Patient Services Payments PHL 2807-j Outpatient Hospital Services 536,009,370.10
1 Patient Services Payments PHL 2807-j Ambulatory Surgical Center Services 23,157,724.76
1 Patient Services Payments PHL 2807-j Diagnostic and Treatment Centers 21,520,702.12
1 Patient Services Payments PHL 2807-j Clinical Laboratories 0.00
1 Patient Services Payments PHL 2807-s Inpatient Hospital Services 1,659,025.00
1 Health Facility Cash Assessment Program PHL 2807-d Nursing Facility Services (6.0%) 151,922,881.42
1 Health Facility Cash Assessment Program PHL 2807-d Nursing Facility Services (5.0%) 8,433.01
1 Health Facility Cash Assessment Program PHL 2807-d Inpatient Hospital Services (.35%) 82,758,130.82
1 Health Facility Cash Assessment Program PHL 3614-a & b Home Health Care Services (.35%) 1,432,262.32
1 Health Facility Cash Assessment Program PHL 3614-a & b LT Home Health Care Services (.35%) 32,601.50
5 Health Facility Cash Assessment Program Social Services Law 367-i Personal Care Providers (.35%) 1,864,851.02
1 Health Facility Cash Assessment Program Section 90 of Part H of Chapter 59 of the Laws of 2011 LT Home Health Care Services (.7%) 0.00
1 Health Facility Cash Assessment Program Section 90 of Part H of Chapter 59 of the Laws of 2011 Nursing Facility Services (.8%) 20,255,833.73
1 Health Facility Cash Assessment Program PHL 2807-dd Nursing Facility Services (.4%) 0.00
1 Health Facility Cash Assessment Program PHL 2807-dd Nursing Facility Services (.2%) 0.00
1 Hospital Quality Contribution Report PHL 2807-d-1 Inpatient Hospital Services (1.6%) 18,781,248.00
  Total     1,600,492,169.85

I certify that this report represents a true and accurate statement of actual cash revenues collected by the above agency during the quarter described above.

Dated:    March 11, 2024                           Signature:     Emily Hoops-Darling                                                                     Title:

Codes: 1 - Permissible