Health care provider tax rates applied for taxes levied under an arrangement other than a percentage of revenues in state fiscal year 2009

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 Tax rate 4 Health care services or providers subjected to health care provider tax rate 4 Description of tax rate 4
Alabama 1899.96 Nursing facility services NUMBER OF BEDS 0.10 Outpatient prescription drugs PER PRESCRIPTION . .   . .  
California 10.12 Nursing facility services THE AB 1629 QUALITY ASSURANCE FEE (QAF) IS ASSESSED ON A DOLLAR AMOUNT PER BED DAY APPLIED TO SKILLED NURSING FACILITIES (A DIFFERENT RATE IS APPLIED TO FACILITIES WITH <100,000 BED DAYS AND >=100,000 BED DAYS). *A MID-YEAR FEE ADJUSTMENT TOOK EFFECT ON JANUARY 1, 2012. 11.16 Nursing facility services THE AB 1629 QUALITY ASSURANCE FEE (QAF) IS ASSESSED ON A DOLLAR AMOUNT PER BED DAY APPLIED TO SKILLED NURSING FACILITIES (A DIFFERENT RATE IS APPLIED TO FACILITIES WITH <100,000 BED DAYS AND >=100,000 BED DAYS). *A MID-YEAR FEE ADJUSTMENT TOOK EFFECT ON JANUARY 1, 2012. . .   . .  
Colorado 6.59 Nursing facility services FEES ARE ASSESSED ON NON-MEDICARE PATIENT DAYS. FACILITIES WITH OVER 55,000 PATIENT DAYS RECEIVE AN 85% DISCOUNTED FEE RATE. IT WAS IMPLEMENTED IN SFY 2009. . .   . .   . .  
Connecticut 12.20 Nursing facility services DOLLAR AMOUNT PER RESIDENT DAY 15.90 Nursing facility services DOLLAR AMOUNT PER RESIDENT DAY . .   . .  
District of Columbia 4411.00 Nursing facility services THE NURSING HOME PROVIDER TAX IS BRAOD BASED AND UNIFORMLY APPLIED. THE RATE IS CALCULATED BY TAKING THE TOTAL DC NURSING FACILITIES GROSS REVENUE AND MUTILPYING THE TOTAL REVENUE BY A PERCENTAGE. THE % OF THE CEILING OF GROSS REVENUE IS THEN DIVIDED BY THE TOTAL NURSING HOMES SKILLED LICENSED BED TO ARRIVE WITH A UNIFORM TAX AMOUNT . .   . .   . .  
Florida 15.89 Nursing facility services DOLLAR AMOUNT PER BED DAY 2.78 Nursing facility services DOLLAR AMOUNT PER BED DAY 14.83 Intermediate care facility services for individuals with intellectual disabilities PER-RESIDENT DAY ASSESSMENT RATE. . .  
Georgia 12.21 Nursing facility services AMOUNT PER PATIENT DAY (OR BED DAY) . .   . .   . .  
Illinois 218.38 Inpatient hospital services THE STATE ASSESSED UNOCCUPIED HOSPITAL BEDS FOR INPATIENT SERVICES AS REPORTED ON THE QUARTER ENDING 12/31/2006 MEDICARE COST REPORT WITHOUT SUBSEQUENT CHANGES OR ADJUSTMENTS. 1.50 Nursing facility services LICENSED BEDS . .   . .  
Indiana 2.50 Nursing facility services THE QUALITY ASSESSMENT FEE (QAF) FOR NURSING FACILITIES IS BASED UPON NON-MEDICARE PATIENT DAYS. THE NF QAF WAS EFFECTIVE 7/1/2003 FOR NONSTATE GOVERNMENT OWNED OR OPERATED (NSGO) NURSING FACILITIES AND PRIVATE FACILITIES WITH AT LEAST 70,000 PATIENT DAYS BEING CHARGED $2.50 PER NON-MEDICARE PATIENT DAY, AND PRIVATE FACILITIES WITH LESS THAN 70,000 PATIENT DAYS BEING CHARGED $10 PER NON-MEDICARE PATIENT DAY. ON 7/1/2011, IT CHANGED TO THE FOLLOWING TO THE FOLLOWING: • PRIVATELY OWNED OR OPERATED NURSING FACILITIES WITH LESS THAN 70,000 PATIENT DAYS, FOURTEEN DOLLARS AND SEVENTY CENTS ($14.70) PER NON-MEDICARE DAY. • PRIVATELY OWNED OR OPERATED NURSING FACILITIES WITH 70,000 OR MORE PATIENT DAYS, THREE DOLLARS AND SIXTY-EIGHT CENTS ($3.68) PER NON-MEDICARE DAY. • NSGO NURSING FACILITIES THAT BECAME NONSTATE GOVERNMENT OWNED OR OPERATED BEFORE JULY 1, 2003, THREE DOLLARS AND SIXTY-EIGHT CENTS ($3.68) PER NON-MEDICARE DAY. • NSGO NURSING FACILITIES THAT BECAME NSGO ON OR AFTER JULY 1, 2003, FOURTEEN DOLLARS AND SEVENTY CENTS ($14.70) PER NON-MEDICARE DAY. EFFECTIVE 10/1/2011, THE FEES CHANGED TO • PRIVATELY OWNED OR OPERATED NURSING FACILITIES WITH TOTAL ANNUAL NURSING FACILITY CENSUS DAYS FEWER THAN SEVENTY THOUSAND (70,000), SIXTEEN DOLLARS ($16) PER NON-MEDICARE DAY. • PRIVATELY OWNED OR OPERATED NURSING FACILITIES WITH TOTAL ANNUAL NURSING FACILITY CENSUS DAYS EQUAL TO OR GREATER THAN SEVENTY THOUSAND (70,000), FOUR DOLLARS ($4) PER NON-MEDICARE DAY. • NONSTATE GOVERNMENT OWNED OR OPERATED (NSGO) NURSING FACILITIES THAT BECAME NSGO BEFORE JULY 1, 2003, FOUR DOLLARS ($4) PER NON-MEDICARE DAY. (NOTE – THERE ARE VERY FEW OF THESE FACILITIES IN THE STATE AT THIS TIME. I BELIEVE THAT THERE MAY BE 3 OR LESS.) • NONSTATE GOVERNMENT OWNED OR OPERATED NURSING FACILITIES THAT BECAME NONSTATE GOVERNMENT OWNED OR OPERATED ON OR AFTER JULY 1, 2003, SIXTEEN DOLLARS ($16) PER NON-MEDICARE DAY. INDIANA STATE FISCAL YEAR: JULY 1 - JUNE 30 10.00 Nursing facility services THE QUALITY ASSESSMENT FEE (QAF) FOR NURSING FACILITIES IS BASED UPON NON-MEDICARE PATIENT DAYS. THE NF QAF WAS EFFECTIVE 7/1/2003 FOR NONSTATE GOVERNMENT OWNED OR OPERATED (NSGO) NURSING FACILITIES AND PRIVATE FACILITIES WITH AT LEAST 70,000 PATIENT DAYS BEING CHARGED $2.50 PER NON-MEDICARE PATIENT DAY, AND PRIVATE FACILITIES WITH LESS THAN 70,000 PATIENT DAYS BEING CHARGED $10 PER NON-MEDICARE PATIENT DAY. ON 7/1/2011, IT CHANGED TO THE FOLLOWING TO THE FOLLOWING: • PRIVATELY OWNED OR OPERATED NURSING FACILITIES WITH LESS THAN 70,000 PATIENT DAYS, FOURTEEN DOLLARS AND SEVENTY CENTS ($14.70) PER NON-MEDICARE DAY. • PRIVATELY OWNED OR OPERATED NURSING FACILITIES WITH 70,000 OR MORE PATIENT DAYS, THREE DOLLARS AND SIXTY-EIGHT CENTS ($3.68) PER NON-MEDICARE DAY. • NSGO NURSING FACILITIES THAT BECAME NONSTATE GOVERNMENT OWNED OR OPERATED BEFORE JULY 1, 2003, THREE DOLLARS AND SIXTY-EIGHT CENTS ($3.68) PER NON-MEDICARE DAY. • NSGO NURSING FACILITIES THAT BECAME NSGO ON OR AFTER JULY 1, 2003, FOURTEEN DOLLARS AND SEVENTY CENTS ($14.70) PER NON-MEDICARE DAY. EFFECTIVE 10/1/2011, THE FEES CHANGED TO • PRIVATELY OWNED OR OPERATED NURSING FACILITIES WITH TOTAL ANNUAL NURSING FACILITY CENSUS DAYS FEWER THAN SEVENTY THOUSAND (70,000), SIXTEEN DOLLARS ($16) PER NON-MEDICARE DAY. • PRIVATELY OWNED OR OPERATED NURSING FACILITIES WITH TOTAL ANNUAL NURSING FACILITY CENSUS DAYS EQUAL TO OR GREATER THAN SEVENTY THOUSAND (70,000), FOUR DOLLARS ($4) PER NON-MEDICARE DAY. • NONSTATE GOVERNMENT OWNED OR OPERATED (NSGO) NURSING FACILITIES THAT BECAME NSGO BEFORE JULY 1, 2003, FOUR DOLLARS ($4) PER NON-MEDICARE DAY. (NOTE – THERE ARE VERY FEW OF THESE FACILITIES IN THE STATE AT THIS TIME. I BELIEVE THAT THERE MAY BE 3 OR LESS.) • NONSTATE GOVERNMENT OWNED OR OPERATED NURSING FACILITIES THAT BECAME NONSTATE GOVERNMENT OWNED OR OPERATED ON OR AFTER JULY 1, 2003, SIXTEEN DOLLARS ($16) PER NON-MEDICARE DAY. INDIANA STATE FISCAL YEAR: JULY 1 - JUNE 30 . .   . .  
Louisiana 14.30 Nursing facility services DOLLAR AMOUNT ($14.30)PER BED DAY 8.02 Intermediate care facility services for individuals with intellectual disabilities DOLLAR AMOUNT($8.02) PER BED DAY 0.10 Outpatient prescription drugs DOLLAR AMOUNT ($.10) PER PRESCRIPTION . .  
Massachusetts 11.45 Nursing facility services DOLLAR AMOUNT PER NON-MEDICARE PATIENT DAY 11.59 Nursing facility services DOLLAR AMOUNT PER NON-MEDICARE PATIENT DAY 1.15 Nursing facility services DOLLAR AMOUNT PER NON-MEDICARE PATIENT DAY 1.16 Nursing facility services DOLLAR AMOUNT PER NON-MEDICARE PATIENT DAY
Minnesota 2815.00 Nursing facility services FLAT AMOUNT OF $2,815 PER LICENSED BED, PER YEAR. 1040.00 Intermediate care facility services for individuals with intellectual disabilities $1,040 PER LICNSED BED PER YEAR. . .   . .  
Mississippi 10.63 Nursing facility services DOLLAR AMOUNT PER OCCUPIED BED DAY - AVERAGE ANNUAL RATES ARE ROUNDED TO AN INTEGER BELOW 15.82 Intermediate care facility services for individuals with intellectual disabilities DOLLAR AMOUNT PER OCCUPIED BED DAY - AVERAGE ANNUAL RATES ARE ROUNDED TO AN INTEGER BELOW 17.95 Psychological services PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES - DOLLAR AMOUNT PER OCCUPIED BED DAY - AVERAGE ANNUAL RATES ARE ROUNDED TO AN INTEGER BELOW 3.25 Inpatient hospital services PER LICENSED BED
Missouri 8.42 Nursing facility services DOLLAR AMOUNT PEROCCUPIED LICENSED BED FROM QUARTERLY SURVYS WHICH ARE COMPLETED BY ALL NURSING FACILITIES . .   . .   . .  
Montana 50.00 Inpatient hospital services DOLLAR AMOUNT PER BED DAY 8.30 Nursing facility services DOLLAR AMOUNT PER BED DAY . .   . .  
New Jersey 11.92 Nursing facility services $11.92 PER BED 10.00 Inpatient hospital services $10 ASSESSMENT ON ADMISSION . .   . .  
North Carolina 5.00 Nursing facility services THE ASSESSMENT IS APPLIED TO ALL NON-MEDICARE BED DAYS. THERE ARE TWO PER BED DAY RATES. THE LOWER RATE IS FOR THOSE PROVIDERS WHOSE ANNUAL BEDS DAYS ARE GREATER THAN 48,000; THE HIGHER RATE IS FOR THOSE FACILITIES WITH ANNUAL BED DAYS AT 48,000 OR LESS. 11.50 Nursing facility services THE ASSESSMENT IS APPLIED TO ALL NON-MEDICARE BED DAYS. THERE ARE TWO PER BED DAY RATES. THE LOWER RATE IS FOR THOSE PROVIDERS WHOSE ANNUAL BEDS DAYS ARE GREATER THAN 48,000; THE HIGHER RATE IS FOR THOSE FACILITIES WITH ANNUAL BED DAYS AT 48,000 OR LESS. 9.33 Intermediate care facility services for individuals with intellectual disabilities TAX IS APPLIED ON ALL NON-MEDICARE BED DAYS. . .  
North Dakota 16.50 Intermediate care facility services for individuals with intellectual disabilities PER DAY RATE BASED ON THE NUMBER OF BEDS LICENSED AT THE BEGINNING OF EACH QUARTER . .   . .   . .  
Ohio 6.25 Nursing facility services LICENSED BEDS - AMOUNTS BELOW PER BED DAY. 11.98 Intermediate care facility services for individuals with intellectual disabilities NO. OF CERTIFIED MEDICAID BEDS. AMOUNTS BELOW PER BED DAY. . .   . .  
Oklahoma 6.70 Nursing facility services DOLLAR AMOUNT PER BED 7.94 Nursing facility services DOLLAR AMOUNT PER BED 6.16 Nursing facility services DOLLAR AMOUNT PER BED . .  
Pennsylvania 2.30 Nursing facility services DOLLAR AMOUNT PER NON-MEDICARE DAY OF SERVICE. DOLLAR AMOUNTS APPLY TO (1) CONTINUING CARE RETIREMENT COMMUNITIES, NURSING FACILITIES WITH 50 BEDS OR LESS AND COUNTY FACILITIES AND (2) ALL OTHER FACILITIES 23.75 Nursing facility services DOLLAR AMOUNT PER NON-MEDICARE DAY OF SERVICE. DOLLAR AMOUNTS APPLY TO (1) CONTINUING CARE RETIREMENT COMMUNITIES, NURSING FACILITIES WITH 50 BEDS OR LESS AND COUNTY FACILITIES AND (2) ALL OTHER FACILITIES . .   . .  
South Carolina 8.50 Intermediate care facility services for individuals with intellectual disabilities AMOUNT PER PATIENT DAY . .   . .   . .  
Tennessee 2225.00 Nursing facility services DOLLAR AMOUNT PER BED PER YEAR . .   . .   . .  
Utah 10.20 Nursing facility services AMOUNT PER NON-MEDICARE BED DAY 6.53 Intermediate care facility services for individuals with intellectual disabilities PROVIDER TAX/DOLLAR AMOUNT ASSESSED ON ICF /ID FACILITY SERVICES "PER BED DAY" . .   . .  
Vermont 4509.67 Nursing facility services NURSING HOME PROVIDER TAX RATES ARE ASSESSED ON A PER-BED BASIS. 0.10 Outpatient prescription drugs THE PHARMACY TAX IS PAID BASED ON THE # OF PRESCRIPTIONS FILLED, AT $0.10 PER SCRIPT. . .   . .  
Wisconsin 75.00 Nursing facility services THE ASSESSMENT IS A FIXED RATE APPLIED MONTHLY ON THE NUMBER OF LICENSED BEDS IN THE FACILITY. 638.00 Intermediate care facility services for individuals with intellectual disabilities THE ASSESSMENT IS A FIXED RATE APPLIED MONTHLY ON THE NUMBER OF LICENSED BEDS IN THE FACILITY. . .   . .  

Source: GAO analysis of state-reported data. | GAO-15-227SP
 
Note: 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.

 

Definition
 
Health care provider taxes are taxes, licensures or other fees, assessments, or other mandatory payments, imposed on health care services or providers, as defined in Section 1903 of the Social Security Act and in 42 C.F.R. § 433.55 - Health Care-Related Taxes Defined.