| Health care provider tax rates applied for taxes levied as percentage of net patient service revenues in state fiscal year 2011 |
| State | Tax rate 1 | Health care services or providers subjected to health care provider tax rate 1 | Description of tax rate 1 | Tax rate 2 | Health care services or providers subjected to health care provider tax rate 2 | Description of tax rate 2 | Tax rate 3 | Health care services or providers subjected to health care provider tax rate 3 | Description of tax rate 3 |
|---|---|---|---|---|---|---|---|---|---|
| Arkansas | 5.500% | Nursing facility services | PERCENTAGE OF NET PATIENT SERVICES REVENUES | 5.500% | Intermediate care facility services for individuals with intellectual disabilities | PERCENTAGE OF NET PATIENT SERVICES REVENUES | 1.113% | Inpatient hospital services | PERCENTAGE OF NET PATIENT SERVICES REVENUES |
| Iowa | 5.500% | Intermediate care facility services for individuals with intellectual disabilities | PERCENTAGE OF NET PATIENT SERVICES REVENUES | 1.260% | Inpatient hospital services | PERCENTAGE OF NET PATIENT SERVICES REVENUES | 1.260% | Outpatient hospital services | PERCENTAGE OF NET PATIENT SERVICES REVENUES |
| Nevada | 5.500% | Nursing facility services | NET PATIENT SERVICES REVENUES | . | . | . | . | ||
| New Hampshire | 5.500% | Inpatient hospital services | PERCENT OF NPSR | 5.500% | Outpatient hospital services | PERCENT OF NPSR | 5.500% | Nursing facility services | PERCENT OF NPSR |
| Rhode Island | 5.314% | Inpatient hospital services | PERCENTAGE OF NET PATIENT SERVICES REVENUES. | 5.314% | Outpatient hospital services | PERCENTAGE OF NET PATIENT SERVICES REVENUES | . | . | |
| South Carolina | 3.600% | Inpatient hospital services | A PERCENTAGE OF NET PATIENT SERVICES REVENUES. | . | . | . | . |
| Source: GAO analysis of state-reported data. | GAO-15-227SP |
| Notes: Only the taxes that states identified as a percentage of net patient service revenues were included in this section. Some states report taxes based on net patient revenues, which are listed in Section 6 of the e-supplement. When counting the total number of taxes, we counted a tax more than once when a tax was levied using different tax rates during a given year. For example, if for 6 months of the year a tax was levied at 4 percent of net patient service revenues, and for the other 6 months the tax was levied at 6 percent of net patient service revenues, we counted this as two taxes. For taxes that were reported as not being levied as a percentage of net patient service revenues, we used a similar approach in counting these taxes. |
| Under federal requirements, states assessing provider taxes must not hold providers harmless (e.g., must not provide a direct or indirect guarantee that providers will receive their money back). However, taxes on net patient service revenues that are at or below a hold-harmless threshold are deemed to comply with the guarantee requirement. The Tax Relief and Health Care Act of 2006 lowered the hold-harmless threshold from 6 percent to 5.5 percent, from January 1, 2008, to September 30, 2011. The threshold returned to 6 percent on October 1, 2011. Pub. L. No. 109-432, § 403, 120 Stat. 2922, 2994-5 (2006). |