Uncompensated trauma care.

WORKING DRAFT
2009
STATE OF
WYOMING
09LSO-0541.E1

HOUSE BILL
NO.
HB0244

Uncompensated trauma care.

Sponsored by:
Representative(s) Cohee
, Harshman, Jorgensen, Lockhart, Lubnau and Millin and Senator(s) Landen

A BILL

for

AN ACT relating to medical care; creating an uncompensated trauma care account; increasing fuel taxes to fund the account; providing a swap of mineral severance tax; providing standards for distribution of funds to acute care hospitals; requiring rulemaking; providing definitions; providing for the automatic repeal of specified sections; and providing for an effective date.

Be It Enacted by the Legislature of the State of
Wyoming
:

Section 1.

W.S. 35
‑
2
‑
1001 through 35
‑
2
‑
1010 are created to read:

ARTICLE 10
UNCOMPENSATED TRAUMA CARE ACCOUNT

35
‑
2
‑
1001.

Uncompensated trauma care account created; standards; rules; definitions.

(a)

There is created an uncompensated trauma care account within the department of health. Effective July 1, 2010, the department shall administer the funds in this account to reimburse acute care hospitals for trauma care provided at acute care hospitals as specified in this section.

(b)

Acute care hospitals shall be reimbursed on a per incident basis, subject to the following:

(i)

There is compliance with the reporting requirements of the
Wyoming
trauma care program registry before the request for reimbursement;

(ii)

Reimbursement shall be available for the costs incurred during the six (6) month period preceding the period subject to paragraph (iii) of this subsection;

(iii)

Requests for reimbursement may be submitted to the department for payment only after one hundred eighty (180) days have elapsed from the date the bill for the services rendered was sent to the patient or his representative.

(c)

The department shall promulgate rules and regulations to administer this reimbursement program on behalf of the state of
Wyoming
. The rules and regulations shall include provisions for:

(i)

Ensuring that reimbursements do not exceed the available funds;

(ii)

Limiting reimbursement to the necessary support of the poor;

(iii)

Preventing duplication between this program and private or public insurance programs;

(iv)

Reimbursing hospitals for trauma service costs and ambulance services for transporting patients to a hospital or emergency room;

(v)

Ensuring that the department shall total all valid requests for reimbursement received and shall pay each applicant a share of the applicant's submitted requests in proportion to the total of the funds available, not to exceed twenty-five percent (25%) of the available funds for the relevant grant cycle.

(d)

The department may contract with a fiscal agent to make the actual payments and conduct any necessary audits of reimbursement requests. Reimbursement requests shall be made in a form and manner prescribed by the department. The department or its agent on its behalf may request any documentation it deems necessary to support any request for reimbursement.

(e)

The department shall not reimburse any one (1) acute care hospital or ambulance service in a cumulative amount greater than twenty-five percent (25%) of the available funds in any calendar year.

(f)

As used in this section:

(i)

"Acute care hospital" means a hospital licensed in
Wyoming
and which provides acute patient care;

(ii)

"Ambulance service" means an ambulance service licensed in Wyoming pursuant to W.S. 33
‑
36
‑
102 through 33
‑
36
‑
113 and which provides emergency medical transportation to hospitals or emergency rooms;

(iii)

"Incident" means an admission, both inpatient and outpatient, involving traumatic care for an individual patient who was injured as a result of a vehicle crash within a one (1) year period to a single hospital. Admissions of the same patient for causes not directly related to an earlier admission shall be considered a separate incident;

(iv)

"Trauma care services" means services to patients with at least one (1) injury diagnosis code, using the International Classification of Diseases, 9
th
Edition, from 800.0 through 904, 925 through 929, 940 through 959.9 and 994.7, plus

at least one (1) of the following:

(A)

Hospitalization for one (1) calendar day;

(B)

Admission to the intensive care unit or monitored bed unit;

(C)

Cardiac or respiratory arrest on route to the hospital or emergency room;

(D)

Dead on arrival at the facility;

(E)

Transfer from or to another acute care hospital;

(F)

Admission directly from the emergency room to the operating room;

(G)

Trauma team activation;

(H)

Meets prehospital triage criteria;

(J)

Ambulance services providing patient transportation to a hospital or emergency room.

(v)

"Vehicle" means as defined in W.S. 31
‑
5
‑
102(a)(lviii).

35
‑
2
‑
1002.

Severance tax distributions into fund.

Before making distributions from the severance tax distribution account under
W.S. 39
‑
14
‑
801
(e)(iv), an amount equal to the amoun
t of tax collected under W.S. 35
‑
2
‑
10
0
4
(b) and 35
‑
2
‑
1007(b)
for the same period shall be distributed to the uncompensated trauma care account created by W.S. 35
‑
2
‑
1001
. Amounts distributed to the uncompensated trauma care account under this subsection shall not exceed the total amount otherwise distributed to the highway fund under
W.S. 39
‑
14
‑
801
(e)(iv).

35
‑
2
‑
1003.

Imposition of gasoline tax.

The tax imposed by W.S.
35
‑
2
‑
1004
(b)
shall cease to be collected on the first day of the third month following the date the department of health notifies the director of the department of transportation that the balance of the
uncompensated trauma care account created by W.S. 35
‑
2
‑
1001
exceeds three million dollars ($3,000,000.00). The tax shall again be collected beginning on the first day of the third month following the date the department of health notifies the director of the department of transportation that the balance of the
uncompensated trauma care
account has fallen below two million dollars ($2,000,000.00).

35
‑
2
‑
1004.

Taxation
r
ate–gasoline tax.

(a)

From July 1, 2009 to June 30, 2011, the total tax imposed by W.S. 39
‑
17
‑
104(a) shall be fifteen cents ($.15) per gallon.

(b)

Within the total tax authorized by subsection (a) of this section and i
n addition to the tax collected pursuant to
W.S. 39
‑
17
‑
104(a)
(i) through (iii), there is levied and shall be collected a license tax of one cent ($.01) per gallon on all gasoline used, sold or distributed for sale or use in this state except for those fuels exempted under W.S. 39
‑
17
‑
105(a) and (d).

35
‑
2
‑
1005.

Distribution–gasoline tax.

A
ll taxes collected under W.S. 35
‑
2
‑
10
0
4
(b)
shall be transferred to the state treasurer who shall deposit them only into the state highway fund. The provisions of
W.S. 39
‑
17
‑
111
and 39
‑
17
‑
105(c) shall not apply to the tax imposed by W.S. 3
5
‑
2
‑
10
0
4
(b)
. Any refund for any overpayment of this one cent ($.01) tax shall be taken from the tax
es collected pursuant to W.S. 35
‑
2
‑
10
04(b)
.

35
‑
2
‑
1006.

Imposition of diesel tax.

The tax imposed by W.S. 35
‑
2
‑
1007
(b)
shall cease to be collected on the first day of the third month following the date the department of health notifies the director of the department of transportation that the balance of the
uncompensated trauma care account created by W.S. 35
‑
2
‑
1001
exceeds three million dollars ($3,000,000.00). The tax shall again be collected beginning on the first day of the third month following the date the department of health notifies the director of the department of transportation that the balance of the
uncompensated trauma care
account has fallen below two million dollars ($2,000,000.00).

35
‑
2
‑
1007.

Taxation rate–diesel fuel.

(a)

From July 1, 2009 to June 30, 2011, the total tax imposed by W.S. 39
‑
17
‑
204(a) shall be fifteen cents ($.15) per gallon.

(b
)

Within the total tax authorized by subsection (a) of this section and i
n addition to the tax collected pursuant to
W.S. 39
‑
17
‑
204(a)(i)
through (iii), there is levied and shall be collected a license tax of one cent ($.01) per gallon on all diesel fuels used, sold or distributed for sale or use in this state except for those fuels exempted under W.S. 39
‑
17
‑
105(a) and 39
‑
17
‑
205(b)
, (d)
and (e).

35
‑
2
‑
1008.

Distribution–diesel tax.

A
ll taxes collected under W.S. 35
‑
2
‑
1007
(b)
shall be transferred to the state treasurer who shall deposit them only into the state highway fund. The provisions of
W.S. 39
‑
17
‑
211(d)
shall not apply to the tax imposed by W.S.
35
‑
2
‑
1007
(b)
. Any refund for any overpayment or for any other refund authorized by law of this one cent ($.01) tax shall be taken from the taxes
collected pursuant to W.S. 35
‑
2
‑
1007
(b)
.

35
‑
2
‑
1009.

Definitions.

The definitions contained in W.S. 39
‑
17
‑
201 shall apply to this article.

35
‑
2
‑
1010.

Expiration.

W.S. 35
‑
2
‑
1001 through 35
‑
2
‑
1009 are repealed effective June 30, 2011.

Section 2.
W.S. 39
‑
14
‑
801(e)(iv), 39
‑
15
‑
105(a)(v)(C), 39
‑
16
‑
105(a)(v)(B), 39
‑
17
‑
103(a)(i), 39
‑
17
‑
104(a)(intro), 39
‑
17
‑
105(a), 39
‑
17
‑
111(a), 39
‑
17
‑
201(a)(xvi), (xxi), (xxvi) and (xxvii), 39
‑
17
‑
203(a)(i), 39
‑
17
‑
204(a)(intro), 39
‑
17
‑
205(b), (d) and (e), 39
‑
17
‑
209(c)(vi) and 39
‑
17
‑
211(a) are amended to read:

39
‑
14
‑
801.

Severance tax distributions; distribution account created; formula.

(e)

Deposits into the account created by subsection (a) of this section shall be distributed as follows, subject to subsections (b) through (d) of this section:

(iv)

Except as provided in W.S. 35
‑
2
‑
1002, t
o the highway fund, four and thirty-three hundredths percent (4.33%), except that if the total unencumbered revenues within the state park road account created by W.S. 24
‑
14
‑
102 are less than five hundred thousand dollars ($500,000.00) on July 1, 2001 or on July 1 of any even-numbered year thereafter, the state treasurer shall first distribute revenues to that account in an amount equal to five hundred thousand dollars ($500,000.00) less the total unencumbered revenues in the account on July 1 of that year;

39
‑
15
‑
105.

Exemptions.

(a)

The following sales or leases are exempt from the excise tax imposed by this article:

(v)

For the purpose of exempting sales of services and tangible personal property which are alternatively taxed, the following are exempt:

(C)

Sales of gasoline or gasohol taxed under W.S. 39
‑
17
‑
101 through 39
‑
17
‑
111 and of diesel fuels taxed under W.S. 39
‑
17
‑
201 through 39
‑
17
‑
211. The exemption provided by this subparagraph shall not apply to gasoline or gasohol taxed under W.S. 39
‑
17
‑
104(a)(iii)
or 35
‑
2
‑
1004
(b)
or to diesel fuel taxed under W.S. 39
‑
17
‑
204(a)(ii)
or 35
‑
2
‑
1007
(b)
.

39
‑
16
‑
105.

Exemptions.

(a)

The following purchases or leases are exempt from the excise tax imposed by this article:

(v)

For the purpose of exempting sales of services and tangible personal property which are alternatively taxed, the following are exempt:

(B)

Motor vehicle fuel which is subject to taxation under W.S. 39
‑
17
‑
101 through 39
‑
17
‑
111 or 39
‑
17
‑
201 through 39
‑
17
‑
211. The exemption provided by this subparagraph shall not apply to gasoline or gasohol taxed under W.S. 39
‑
17
‑
104(a)(iii)
or 35
‑
2
‑
1004
(b)
or to diesel fuel taxed under W.S. 39
‑
17
‑
204(a)(ii)
or 35
‑
2
‑
1007
(b)
.

39
‑
17
‑
103.

Imposition.

(a)

Taxable event. The following shall apply:

(i)

There is levied and shall be collected a license tax on all gasoline used, sold or distributed for sale or use in this state except for those fuels exempted under W.S. 39
‑
17
‑
105

and as otherwise provided by W.S. 35
‑
2
‑
1003
;

39
‑
17
‑
104.

Taxation rate.

(a)

Except as otherwise provided by this section
, W.S. 35
‑
2
‑
1004
and
W.S.

39
‑
17
‑
105, the total tax on gasoline shall be
fourteen cents ($.14)
per gallon. The rate shall be imposed as follows:

3
9
‑
17
‑
105.

Exemptions.

(a)

Gasoline sold at a Wyoming terminal rack for export, other than in the fuel supply tank of a motor vehicle, by a person licensed as an exporter in this state is exempt from the license tax imposed under W.S. 39
‑
17
‑
104(a)(i) through
(iii)

and 35
‑
2
‑
1004
(b)
. The exempt sales shall be reported on or before the last day of the month in a format required by the department. The sales reports are invalid if not submitted to the department within one (1) year following date of sale.

Gasoline directly exported, other than in the fuel supply tank of a motor vehicle, by a
Wyoming
licensed supplier, is exempt from the additional license tax imposed under W.S. 39
‑
17
‑
104(a)(iii)

and 35
‑
2
‑
1004
(b)
. Exchanges and sales of gasoline between suppliers are exempt from the license tax under this section.

3
9
‑
17
‑
111.

Distribution.

(a)

Except as provided by W.S. 35
‑
2
‑
1005, a
ll gasoline license taxes and fees received by the department under this article shall be transferred to the state treasurer who shall credit them to the proper accounts as specified by the department and in subsection (d) of this section.

3
9
‑
17
‑
201.

Definitions.

(a)

As used in this article:

(xvi)

"Person" means, for purposes of collecting the tax provided by W.S.
35
‑
2
‑
1007
and

39
‑
17
‑
204(a)(ii), an individual, partnership, corporation, joint stock company or other association or entity, public or private;

(xxi)

"Diesel fuels" means those combustible gases and liquids commonly referred to as diesel fuel or any other volatile liquid of less than forty-six (46) degrees American petroleum industry gravity test, except liquid petroleum gas, when actually sold for use in motor vehicles for operation upon public roads and highways. The term "diesel fuels" includes jet fuel which is the volatile substance produced from petroleum, natural gas, oil, shale or coal and sold under the name of jet fuel and kerosene and any type of additive when the additive is mixed or blended into diesel fuel, excluding a pour point depressant. For the purposes of coll
ecting the tax provided by W.S.
35
‑
2
‑
1007
and 3
9
‑
17
‑
204(a)(ii)

the term "diesel fuel" includes all diesel fuel consumed or purchased for any and all purposes;

(xxvi)

"Use" means the consumption of fuel in a motor vehicle upon a highway and includes the reception of diesel fuel into any tank on a motor vehicle which is used by the engine that generates motive power for the vehicle and, for the purposes of collecting the tax provided by W.S.
35
‑
2
‑
1007 and

39
‑
17
‑
204(a)(ii), includes all diesel fuels consumed for any and all purposes;

(xxvii)

"User" means any person who uses diesel fuel within this state in an internal combustion engine for the generation of power to propel a motor vehicle upon a highway and, for the purposes of collecting the tax provided by W.S.
35
‑
2
‑
1007 and
39
‑
17
‑
204(a)(ii), includes any person who uses diesel fuel within this state for any and all purposes;

3
9
‑
17
‑
203.

Imposition.

(a)

Taxable event. The following shall apply:

(i)

There is levied and shall be collected a license tax on all diesel fuels used, sold or distributed for sale or use in this state except for those fuels exempted in W.S. 39
‑
17
‑
205

and as otherwise provided by W.S. 35
‑
2
‑
1006
;

3
9
‑
17
‑
204.

Taxation rate.

(a)

Except as otherwise provided by this section
, W.S. 35
‑
2
‑
1007
and
W.S.
39
‑
17
‑
205, the total tax on diesel fuels shall be
fourteen cents ($.14)
per gallon. The rate shall be imposed as follows:

39
‑
17
‑
205.

Exemptions.

(b)

Diesel fuel sold at a Wyoming terminal rack for export, other than in the fuel supply tank of a motor vehicle, by a person licensed as an exporter in this state is exempt from the license tax imposed under W.S. 39
‑
17
‑
204(a)(i) through
(iii)

and 35
‑
2
‑
1007
(b)
. The exempt sales shall be reported on or before the last day of the month in a format required by the department. The sales reports are invalid if not submitted to the department within one (1) year following the date of sale.

(d)

Dyed diesel fuel as defined in W.S. 39
‑
17
‑
201(a)(ix) is exempt from the license tax under W.S. 39
‑
17
‑
204(a)(i)

and (iv) and 35
‑
2
‑
1007
(b)
.

(e)

Diesel fuel directly exported, other than in the fuel supply tank of a motor vehicle, by a
Wyoming
licensed supplier is exempt from the additional license tax imposed under W.S. 39
‑
17
‑
204(a)(ii)

and 35
‑
2
‑
1007
(b)
.

39
‑
17
‑
209.

Taxpayer remedies.

(c)

Refunds. The following shall apply:

(vi)

The license tax under W.S. 39
‑
17
‑
204(a)(ii)
and 35
‑
2
‑
1007
(b)
is subject to refund on all diesel fuel sold in
Wyoming
for transportation of people, goods and equipment in interstate commerce and used outside
Wyoming
, provided that there is an adequate system for determining whether or not the diesel fuel is used in
Wyoming
. Nothing in this paragraph shall apply to the use, or sale or distribution for use, of diesel fuel in
Wyoming
. The refund request is invalid if not submitted within one (1) year.

39
‑
17
‑
211.

Distribution.

(a)

Except as provided by W.S. 35
‑
2
‑
1008, a
ll diesel fuels license taxes and fees received by the department under this article shall be transferred to the state treasurer who shall credit them to the proper accounts.

Section
3
.

This act is effective July 1, 2009.

(END)

1
HB0244