S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4911
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 8, 2021
                                ___________
 
 Introduced  by M. of A. GOODELL -- read once and referred to the Commit-
   tee on Ways and Means
 
 AN ACT to amend the financial services law, the tax law and  the  public
   health law, in relation to enacting the Health Care Tax Reform Act
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. This act shall be known and may be  cited  as  the  "Health
 Care Tax Reform Act".
   § 2. Legislative findings. The Legislature hereby finds that:
   (a) The affordability of health care and health insurance is extremely
 important  in  ensuring  that the maximum number of New York State resi-
 dents can obtain high quality affordable health care;
   (b) Health care and health insurance are currently subject to  several
 taxes that directly and indirectly increase the cost of health insurance
 coverage,  including  an annual flat tax on all privately insured people
 in New York State called the covered lives assessment  that  raises  the
 costs  to  health  plans by $1.1 Billion, a 9.63% sales tax surcharge on
 certain  hospital  based  health  services  that  costs  consumers  $3.6
 Billion,  a  1.75%  flat tax on all commercial health insurance policies
 that costs consumers $350 Million, and a gross receipts tax on insurance
 companies called a section 206 assessment that costs health  plans  $149
 Million a year;
   (c)  Collectively,  the taxes on health care and health insurance cost
 consumers a total of over $5 Billion in 2018, which  exceeds  the  total
 amount  of  taxes  paid  by corporations through the franchise taxes and
 exceeds all other types of taxes except for personal  income  taxes  and
 general sales taxes; and
   (d)  The  taxes  on health care and health insurance are fundamentally
 regressive taxes because the taxes are unrelated to a consumer's  wealth
 or  ability to pay, directly impact hospitalization costs at a time when
 consumers are facing some of  their  greatest  health  care  challenges,

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD09027-01-1

 A. 4911                             2
 
 directly  increase  the cost of health insurance, and are counterproduc-
 tive to the public  policy  objective  of  making  health  insurance  as
 affordable as possible.
   §  3. Section 206 of the financial services law is amended by adding a
 new subsection (g) to read as follows:
   (G) FOR THE FISCAL YEAR COMMENCING ON APRIL FIRST, TWO THOUSAND  TWEN-
 TY-ONE,  THE  COMMISSIONER  SHALL  ONLY COLLECT EIGHTY PER CENTUM OF ANY
 ASSESSMENTS COLLECTED PURSUANT  TO  THIS  SECTION  IN  THE  FISCAL  YEAR
 COMMENCING  ON  APRIL  FIRST,  TWO  THOUSAND  TWENTY-TWO,  AND  PROVIDED
 FURTHER, HOWEVER, THAT FOR THE FISCAL YEAR COMMENCING  ON  APRIL  FIRST,
 TWO  THOUSAND TWENTY-FOUR, THE COMMISSIONER SHALL ONLY COLLECT SIXTY PER
 CENTUM OF ANY ASSESSMENTS COLLECTED PURSUANT  TO  THIS  SECTION  IN  THE
 FISCAL  YEAR  COMMENCING  ON  APRIL  FIRST, TWO THOUSAND TWENTY-TWO, AND
 PROVIDED FURTHER, HOWEVER, THAT FOR THE FISCAL YEAR COMMENCING ON  APRIL
 FIRST,  TWO  THOUSAND  TWENTY-FIVE,  THE COMMISSIONER SHALL ONLY COLLECT
 FORTY PER CENTUM OF ANY ASSESSMENTS COLLECTED PURSUANT TO  THIS  SECTION
 IN  THE  FISCAL YEAR COMMENCING ON APRIL FIRST, TWO THOUSAND TWENTY-TWO,
 AND PROVIDED FURTHER, HOWEVER, THAT FOR THE FISCAL  YEAR  COMMENCING  ON
 APRIL  FIRST,  TWO  THOUSAND  TWENTY-SIX,  THE  COMMISSIONER  SHALL ONLY
 COLLECT TWENTY PER CENTUM OF ANY ASSESSMENTS COLLECTED PURSUANT TO  THIS
 SECTION IN THE FISCAL YEAR COMMENCING ON APRIL FIRST, TWO THOUSAND TWEN-
 TY-TWO, AND PROVIDED FURTHER, HOWEVER, THAT FOR THE FISCAL YEAR COMMENC-
 ING  ON APRIL FIRST, TWO THOUSAND TWENTY-SEVEN, NO SUCH ASSESSMENT UNDER
 THIS SECTION SHALL BE COLLECTED.
   § 4. Section 1502-a of the tax law, as amended by section  2  of  part
 B-1  of chapter 57 of the laws of 2009 and as further amended by section
 104 of part A of chapter 62 of the laws of 2011, is amended to  read  as
 follows:
   § 1502-a.  Tax  on non-life insurance corporations. (A) In lieu of the
 tax imposed by section fifteen hundred one of this article, every domes-
 tic insurance corporation, every foreign insurance corporation and every
 alien insurance corporation, other than  such  corporations  transacting
 the  business  of life insurance, (1) authorized to transact business in
 this state under a certificate of authority from the  superintendent  of
 financial  services[,]  OR (2) that is a risk retention group as defined
 in subsection (n) of section five  thousand  nine  hundred  two  of  the
 insurance  law,  [or  (3)  that  is  a  health  maintenance organization
 required to obtain a certificate of authority under  article  forty-four
 of the public health law,] shall, for the privilege of exercising corpo-
 rate  franchises or for carrying on business in a corporate or organized
 capacity within this state, and in addition to any other  taxes  imposed
 for  such privilege, pay a tax on all gross direct premiums, less return
 premiums thereon, written on risks located or resident  in  this  state.
 The  tax  imposed  by  this  section shall be computed in the manner set
 forth in subdivision (a) of section fifteen hundred ten of this  article
 as  such  subdivision  applied to taxable years beginning before January
 first, two thousand three, except that the rate of tax imposed  by  this
 section  shall  be [one and seventy-five hundredths percent on all gross
 direct premiums, less return premiums thereon, for accident  and  health
 insurance  contracts, including contracts with health maintenance organ-
 izations for health services, and]  two  percent  on  all  [other]  such
 premiums  EXCEPT  ACCIDENT  AND  HEALTH  INSURANCE  CONTRACTS, INCLUDING
 CONTRACTS WITH HEALTH MAINTENANCE ORGANIZATIONS FOR HEALTH SERVICES.
   (B) IN LIEU OF THE TAX IMPOSED BY SECTION FIFTEEN HUNDRED ONE OF  THIS
 ARTICLE,  EVERY  DOMESTIC INSURANCE CORPORATION, EVERY FOREIGN INSURANCE
 CORPORATION AND EVERY  ALIEN  INSURANCE  CORPORATION,  OTHER  THAN  SUCH

 A. 4911                             3
 
 CORPORATIONS TRANSACTING THE BUSINESS OF LIFE INSURANCE THAT IS A HEALTH
 MAINTENANCE  ORGANIZATION  REQUIRED TO OBTAIN A CERTIFICATE OF AUTHORITY
 UNDER ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW, SHALL, FOR THE PRIVI-
 LEGE OF EXERCISING CORPORATE FRANCHISES OR FOR CARRYING ON BUSINESS IN A
 CORPORATE  OR  ORGANIZED  CAPACITY WITHIN THIS STATE, AND IN ADDITION TO
 ANY OTHER TAXES IMPOSED FOR SUCH PRIVILEGE,  PAY  A  TAX  ON  ALL  GROSS
 DIRECT  PREMIUMS, LESS RETURN PREMIUMS THEREON, WRITTEN ON RISKS LOCATED
 OR RESIDENT IN THIS STATE. THE TAX IMPOSED  BY  THIS  SECTION  SHALL  BE
 COMPUTED  IN  THE MANNER SET FORTH IN SUBDIVISION (A) OF SECTION FIFTEEN
 HUNDRED TEN OF THIS ARTICLE AS SUCH SUBDIVISION APPLIED TO TAXABLE YEARS
 BEGINNING BEFORE JANUARY FIRST, TWO THOUSAND THREE, EXCEPT THAT THE RATE
 OF TAX IMPOSED BY THIS SECTION SHALL BE ONE AND SEVENTY-FIVE  HUNDREDTHS
 PERCENT  ON ALL GROSS DIRECT PREMIUMS, LESS RETURN PREMIUMS THEREON, FOR
 ACCIDENT AND HEALTH INSURANCE CONTRACTS, INCLUDING CONTRACTS WITH HEALTH
 MAINTENANCE ORGANIZATIONS FOR HEALTH SERVICES, PROVIDED,  HOWEVER,  THAT
 FOR THE TAXABLE YEAR BEGINNING JANUARY FIRST, TWO THOUSAND TWENTY-THREE,
 THE  PERCENTAGE  SHALL  BE  ONE  AND  FOUR  TENTHS PERCENT, AND PROVIDED
 FURTHER, HOWEVER, THAT FOR THE TAXABLE YEAR BEGINNING JANUARY FIRST, TWO
 THOUSAND TWENTY-FOUR, THE PERCENTAGE SHALL BE ONE  AND  FIVE  HUNDREDTHS
 PERCENT, AND PROVIDED FURTHER, HOWEVER, THAT FOR THE TAXABLE YEAR BEGIN-
 NING  JANUARY  FIRST,  TWO THOUSAND TWENTY-FIVE, THE PERCENTAGE SHALL BE
 SEVEN TENTHS OF ONE PERCENT, AND PROVIDED FURTHER, HOWEVER, THAT FOR THE
 TAXABLE YEAR BEGINNING  JANUARY  FIRST,  TWO  THOUSAND  TWENTY-SIX,  THE
 PERCENTAGE SHALL BE THIRTY-SEVEN HUNDREDTHS OF ONE PERCENT, AND PROVIDED
 FURTHER,  HOWEVER,  THAT  FOR  THE  TAXABLE YEARS BEGINNING ON AND AFTER
 JANUARY FIRST, TWO THOUSAND TWENTY-SEVEN, NO SUCH TAX SHALL BE IMPOSED.
   (C) All the other provisions in section fifteen hundred  ten  of  this
 article as amended from time to time, other than subdivision (b) of such
 section,  shall  apply  to  the tax imposed by this section. In no event
 shall the tax imposed under this section be less than two hundred  fifty
 dollars.
   §  5.  Subdivision  2  of  section 2807-j of the public health law, as
 amended by section 41 of part B of chapter 58 of the laws  of  2005  and
 paragraphs  (b), (c), (d), and (e) as amended by section 50 of part B of
 chapter 58 of the laws of 2009, is amended to read as follows:
   2. (a) The total percentage allowance for any period during the period
 January first, nineteen hundred ninety-seven  through  December  thirty-
 first,  nineteen hundred ninety-nine and on and after January first, two
 thousand, for a designated provider of services applicable  to  a  payor
 shall  be  determined in accordance with this subdivision and applied to
 net patient service revenues.
   (b) The total percentage allowance for each payor, other than  govern-
 mental  agencies,  or  health  maintenance  organizations  for  services
 provided to subscribers eligible  for  medical  assistance  pursuant  to
 title  eleven  of  article  five of the social services law, or approved
 organizations for services provided  to  subscribers  eligible  for  the
 family health plus program pursuant to title eleven-D of article five of
 the  social services law, and other than payments for a patient that has
 no third-party coverage in whole or in part for services provided  by  a
 designated provider of services, shall be:
   (i)  the  sum  of (A) eight and eighteen-hundredths percent, provided,
 however, that for services provided on and after July first,  two  thou-
 sand  three,  the  percentage  shall be eight and eighty-five hundredths
 percent, and further provided that for services provided  on  and  after
 January first, two thousand six, the percentage shall be eight and nine-
 ty-five  hundredths  percent,  and  further  provided  that for services

 A. 4911                             4
 
 provided on and after April first, two  thousand  nine,  the  percentage
 shall  be  nine and sixty-three hundredths percent, AND FURTHER PROVIDED
 THAT FOR SERVICES PROVIDED ON AND AFTER APRIL FIRST, TWO THOUSAND  TWEN-
 TY-TWO,  THE  PERCENTAGE  SHALL  BE  TWENTY-TWO AND SIXTY-ONE HUNDREDTHS
 PERCENT, AND FURTHER PROVIDED THAT FOR SERVICES PROVIDED  ON  AND  AFTER
 APRIL  FIRST, TWO THOUSAND TWENTY-THREE, THE PERCENTAGE SHALL BE SIXTEEN
 AND  NINETY-SIX  HUNDREDTHS  PERCENT,  AND  FURTHER  PROVIDED  THAT  FOR
 SERVICES  PROVIDED  ON  AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-FOUR,
 THE PERCENTAGE SHALL BE ELEVEN AND THIRTY-ONE  HUNDREDTHS  PERCENT,  AND
 FURTHER  PROVIDED  THAT  FOR SERVICES PROVIDED ON AND AFTER APRIL FIRST,
 TWO THOUSAND TWENTY-FIVE, THE PERCENTAGE SHALL BE  FIVE  AND  SIXTY-FIVE
 HUNDREDTHS  PERCENT,  AND FURTHER PROVIDED THAT FOR SERVICES PROVIDED ON
 AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-SIX, THE PERCENTAGE SHALL  BE
 ZERO  PERCENT, plus (B) twenty-four percent, provided, however, that for
 services provided on and after  July  first,  two  thousand  three,  the
 percentage shall be twenty-five and ninety-seven hundredths percent, and
 further  provided that for services provided on and after January first,
 two thousand six, the percentage  shall  be  twenty-six  and  twenty-six
 hundredths  percent,  and further provided that for services provided on
 and after April first, two thousand nine, the percentage shall be  twen-
 ty-eight  and twenty-seven hundredths percent, AND FURTHER PROVIDED THAT
 FOR SERVICES PROVIDED ON AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-TWO,
 THE PERCENTAGE SHALL BE TWENTY-TWO AND SIXTY-ONE HUNDREDTHS PERCENT, AND
 FURTHER PROVIDED THAT FOR SERVICES PROVIDED ON AND  AFTER  APRIL  FIRST,
 TWO  THOUSAND  TWENTY-THREE, THE PERCENTAGE SHALL BE SIXTEEN AND NINETY-
 SIX HUNDREDTHS PERCENT, AND FURTHER PROVIDED THAT FOR SERVICES  PROVIDED
 ON AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-FOUR, THE PERCENTAGE SHALL
 BE  ELEVEN  AND THIRTY-ONE HUNDREDTHS PERCENT, AND FURTHER PROVIDED THAT
 FOR SERVICES PROVIDED ON AND AFTER APRIL  FIRST,  TWO  THOUSAND  TWENTY-
 FIVE,  THE  PERCENTAGE  SHALL BE FIVE AND SIXTY-FIVE HUNDREDTHS PERCENT,
 AND FURTHER PROVIDED THAT FOR  SERVICES  PROVIDED  ON  AND  AFTER  APRIL
 FIRST,  TWO  THOUSAND  TWENTY-SIX, THE PERCENTAGE SHALL BE ZERO PERCENT,
 and plus (C) for a specified third-party payor as defined in subdivision
 one-a of section  twenty-eight  hundred  seven-s  of  this  article  the
 percentage  allowance  applicable  for  a general hospital for inpatient
 hospital services pursuant to subdivision two  of  section  twenty-eight
 hundred seven-s of this article;
   (ii) unless (A) an election in accordance with paragraph (a) of subdi-
 vision five of this section to pay the allowance directly to the commis-
 sioner  or  the  commissioner's  designee is in effect for a third-party
 payor, and in addition (B) for a specified third-party payor an election
 to pay the assessment in accordance with  section  twenty-eight  hundred
 seven-t of this article is in effect.
   (c) If an election in accordance with subdivision five of this section
 is  in effect for a third-party payor and in addition in accordance with
 section twenty-eight hundred seven-t of this  article  for  a  specified
 third-party  payor,  the  total  percentage  allowance  factor  shall be
 reduced to eight and  eighteen-hundredths  percent,  provided,  however,
 that  for  services provided on and after July first, two thousand three
 the total percentage allowance factor shall  be  reduced  to  eight  and
 eighty-five  hundredths  percent, and further provided that for services
 provided on and  after  January  first,  two  thousand  six,  the  total
 percentage  allowance  factor  shall be reduced to eight and ninety-five
 hundredths percent, and further provided that for services  provided  on
 and after April first, two thousand nine, the total percentage allowance
 factor  shall  be reduced to nine and sixty-three hundredths percent AND

 A. 4911                             5
 
 FURTHER PROVIDED THAT FOR SERVICES PROVIDED ON AND  AFTER  APRIL  FIRST,
 TWO  THOUSAND  TWENTY-TWO, THE PERCENTAGE SHALL BE SEVEN AND SEVENTY-ONE
 HUNDREDTHS PERCENT, AND FURTHER PROVIDED THAT FOR SERVICES  PROVIDED  ON
 AND  AFTER  APRIL FIRST, TWO THOUSAND TWENTY-THREE, THE PERCENTAGE SHALL
 BE FIVE AND SEVENTY-NINE HUNDREDTHS PERCENT, AND FURTHER  PROVIDED  THAT
 FOR  SERVICES  PROVIDED  ON  AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-
 FOUR, THE PERCENTAGE SHALL BE THREE AND EIGHTY-SIX  HUNDREDTHS  PERCENT,
 AND  FURTHER  PROVIDED  THAT  FOR  SERVICES  PROVIDED ON AND AFTER APRIL
 FIRST, TWO THOUSAND TWENTY-FIVE, THE PERCENTAGE SHALL BE ONE  AND  NINE-
 TY-THREE  HUNDREDTHS  PERCENT,  AND  FURTHER  PROVIDED THAT FOR SERVICES
 PROVIDED ON AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-SIX, THE PERCENT-
 AGE SHALL BE ZERO PERCENT.
   (d) The total percentage allowance for payments by governmental  agen-
 cies,  as  determined  in  accordance  with  paragraphs (a) and (a-1) of
 subdivision one of section twenty-eight hundred seven-c of this  article
 as  in  effect on December thirty-first, nineteen hundred ninety-six, or
 health maintenance organizations for services  provided  to  subscribers
 eligible for medical assistance pursuant to title eleven of article five
 of  the  social  services  law,  or  approved organizations for services
 provided to subscribers eligible for  the  family  health  plus  program
 pursuant  to  title eleven-D of article five of the social services law,
 shall be five and ninety-eight-hundredths  percent,  provided,  however,
 that  for  services provided on and after July first, two thousand three
 the total percentage allowance shall be six and  forty-seven  hundredths
 percent,  and  further  provided that for services provided on and after
 January first, two thousand six, the total percentage allowance shall be
 six and fifty-four hundredths percent, and  further  provided  that  for
 services provided on and after April first, two thousand nine, the total
 percentage  allowance  shall  be  seven  and four hundredths percent AND
 FURTHER PROVIDED THAT FOR SERVICES PROVIDED ON AND  AFTER  APRIL  FIRST,
 TWO  THOUSAND  TWENTY-TWO,  THE PERCENTAGE SHALL BE FIVE AND SIXTY-THREE
 HUNDREDTHS PERCENT, AND FURTHER PROVIDED THAT FOR SERVICES  PROVIDED  ON
 AND  AFTER  APRIL FIRST, TWO THOUSAND TWENTY-THREE, THE PERCENTAGE SHALL
 BE FOUR AND TWENTY-TWO HUNDREDTHS PERCENT, AND FURTHER PROVIDED THAT FOR
 SERVICES PROVIDED ON AND AFTER APRIL FIRST,  TWO  THOUSAND  TWENTY-FOUR,
 THE  PERCENTAGE  SHALL  BE  TWO  AND  EIGHTY-TWO HUNDREDTHS PERCENT, AND
 FURTHER PROVIDED THAT FOR SERVICES PROVIDED ON AND  AFTER  APRIL  FIRST,
 TWO  THOUSAND  TWENTY-FIVE,  THE  PERCENTAGE  SHALL BE ONE AND FORTY-ONE
 HUNDREDTHS PERCENT, AND FURTHER PROVIDED THAT FOR SERVICES  PROVIDED  ON
 AND  AFTER APRIL FIRST, TWO THOUSAND TWENTY-SIX, THE PERCENTAGE SHALL BE
 ZERO PERCENT.
   (e) The total percentage allowance for payments for services  provided
 by  designated  providers  of services for which there is no third-party
 coverage in whole or in part  shall  be  eight  and  eighteen-hundredths
 percent, provided, however, that for services provided on and after July
 first,  two thousand three the total percentage allowance shall be eight
 and eighty-five  hundredths  percent,  and  further  provided  that  for
 services  provided  on  and  after  January first, two thousand six, the
 total percentage allowance shall be  eight  and  ninety-five  hundredths
 percent,  and  further  provided that for services provided on and after
 April first, two thousand nine, the total percentage allowance shall  be
 nine  and  sixty-three  hundredths percent AND FURTHER PROVIDED THAT FOR
 SERVICES PROVIDED ON AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-TWO, THE
 PERCENTAGE SHALL  BE  SEVEN  AND  SEVENTY-ONE  HUNDREDTHS  PERCENT,  AND
 FURTHER  PROVIDED  THAT  FOR SERVICES PROVIDED ON AND AFTER APRIL FIRST,
 TWO THOUSAND TWENTY-THREE, THE PERCENTAGE SHALL BE FIVE AND SEVENTY-NINE

 A. 4911                             6
 
 HUNDREDTHS PERCENT, AND FURTHER PROVIDED THAT FOR SERVICES  PROVIDED  ON
 AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-FOUR, THE PERCENTAGE SHALL BE
 THREE  AND  EIGHTY-SIX HUNDREDTHS PERCENT, AND FURTHER PROVIDED THAT FOR
 SERVICES  PROVIDED  ON  AND AFTER APRIL FIRST, TWO THOUSAND TWENTY-FIVE,
 THE PERCENTAGE SHALL BE ONE AND  NINETY-THREE  HUNDREDTHS  PERCENT,  AND
 FURTHER  PROVIDED  THAT  FOR SERVICES PROVIDED ON AND AFTER APRIL FIRST,
 TWO THOUSAND TWENTY-SIX, THE PERCENTAGE SHALL BE  ZERO  PERCENT.    This
 paragraph  shall  not  apply  to  patient  deductibles  and  coinsurance
 amounts.
   (f) The total percentage allowance for patient deductibles and coinsu-
 rance amounts shall be  the  same  percentage  allowance  applicable  to
 payments  by  the primary third-party payor covering the patient in each
 case determined in accordance with paragraphs (a), (b) and (c)  of  this
 subdivision.
   (g)  The  total  percentage allowance for secondary third-party payors
 under coordination of benefits principles shall be the  same  percentage
 allowance applicable to payments by the primary third-party payor in the
 case  determined  in accordance with paragraphs (a), (b) and (c) of this
 subdivision.
   § 6. Subdivision 2 of section 2807-s of  the  public  health  law,  as
 added by chapter 639 of the laws of 1996, subparagraph (ii) of paragraph
 (b)  as  amended  by  chapter  1  of  the laws of 1999, paragraph (c) as
 amended by section 15 of part A-3 of chapter 62 of  the  laws  of  2003,
 subparagraph  (ii) of paragraph (c) as amended and subparagraph (iii) of
 paragraph (c) as added by section 31 of part B of chapter 58 of the laws
 of 2005, and subparagraph (iv) of paragraph (c) as added by  section  21
 of  part  A  of  chapter  58  of the laws of 2007, is amended to read as
 follows:
   2. (a) The regional percentage allowance for  any  period  during  the
 period  January  first,  nineteen  hundred ninety-seven through December
 thirty-first, nineteen hundred ninety-nine for all general hospitals  in
 the  region  applicable to a specified third-party payor, and applicable
 to related patient coinsurance and deductible amounts and  to  secondary
 third-party  payors  under coordination of benefits principles, shall be
 the following, and shall be applied to inpatient  hospital  net  patient
 service revenues:
   (b) the result expressed as a percentage of:
   (i)  for each region, the amount allocated to the region in accordance
 with subdivision six of this section, divided by
   (ii) the total estimated nineteen hundred ninety-six general  hospital
 inpatient  revenue of all general hospitals in the region, excluding (A)
 an estimate of revenue from services provided to beneficiaries of  title
 XVIII  of the federal social security act (medicare), (B) an estimate of
 revenue from services provided to  patients  eligible  for  payments  by
 governmental  agencies,  patients  eligible for payments pursuant to the
 comprehensive motor vehicle  insurance  reparations  act,  the  workers'
 compensation  law,  the  volunteer  firefighters'  benefit  law, and the
 volunteer ambulance workers' benefit law,  and  self-pay  patients,  (C)
 from  general  hospitals  providing  graduate  medical  education in the
 aggregate an amount equal to the amount specified in subparagraph (i) of
 this subdivision, other than the components of such amount allocable  to
 payors specified in clause (B) of this subparagraph, and (D) an estimate
 of  revenue  reductions  related to negotiated reimbursement in nineteen
 hundred ninety-seven with specified third-party payors which shall be  a
 uniform statewide percentage estimated reduction.

 A. 4911                             7
 
   (c)  (i)  The  regional  percentage  allowance for the periods January
 first, two thousand through June thirtieth, two thousand three, for  all
 general  hospitals  in  the  region  applicable to specified third-party
 payors, and applicable to related  patient  coinsurance  and  deductible
 amounts,  shall  be  the  same  regional percentage allowance calculated
 pursuant to paragraph (b) of this subdivision  for  the  period  January
 first, nineteen hundred ninety-nine through December thirty-first, nine-
 teen hundred ninety-nine.
   (ii) The regional percentage allowance for the periods July first, two
 thousand three through December thirty-first, two thousand five, for all
 general  hospitals  in  the  region  applicable to specified third-party
 payors, and applicable to related  patient  coinsurance  and  deductible
 amounts,  shall  be  the  same  regional percentage allowance calculated
 pursuant to paragraph (b) of this subdivision  for  the  period  January
 first, nineteen hundred ninety-nine through December thirty-first, nine-
 teen  hundred  ninety-nine  multiplied by one hundred eight and nineteen
 hundredths percent.
   (iii) The regional percentage allowance for the periods January first,
 two thousand six through June thirtieth, two  thousand  seven,  for  all
 general  hospitals  in  the  region  applicable to specified third-party
 payors, and applicable to related  patient  coinsurance  and  deductible
 amounts,  shall  be  the  same  regional percentage allowance calculated
 pursuant to subparagraph (ii) of this paragraph for the  period  January
 first,  two  thousand  five  through December thirty-first, two thousand
 five multiplied by one hundred one and thirteen hundredths percent.
   (iv) The regional percentage allowance for periods [on and after] July
 first, two thousand seven THROUGH MARCH THIRTIETH, TWO THOUSAND  TWENTY-
 TWO,  for  all  general  hospitals in the region applicable to specified
 third-party payors, and applicable to related  patient  coinsurance  and
 deductible  amounts,  shall  be  the  same regional percentage allowance
 calculated pursuant to subparagraph (iii)  of  this  paragraph  for  the
 period January first, two thousand six through June thirtieth, two thou-
 sand seven.
   (V)  THE  REGIONAL  PERCENTAGE  ALLOWANCE FOR PERIODS APRIL FIRST, TWO
 THOUSAND TWENTY-TWO THROUGH MARCH THIRTIETH, TWO THOUSAND  TWENTY-THREE,
 FOR  ALL  GENERAL HOSPITALS IN THE REGION APPLICABLE TO SPECIFIED THIRD-
 PARTY PAYORS, AND APPLICABLE TO RELATED PATIENT COINSURANCE AND  DEDUCT-
 IBLE AMOUNTS, SHALL BE THE SAME REGIONAL PERCENTAGE ALLOWANCE CALCULATED
 PURSUANT  TO  PARAGRAPH  (B)  OF THIS SUBDIVISION FOR THE PERIOD JANUARY
 FIRST, NINETEEN HUNDRED NINETY-NINE THROUGH DECEMBER THIRTY-FIRST, NINE-
 TEEN HUNDRED NINETY-NINE  MULTIPLIED  BY  NINETY-SEVEN  AND  SEVENTY-ONE
 HUNDREDTHS PERCENT.
   (VI)  THE  REGIONAL  PERCENTAGE ALLOWANCE FOR PERIODS APRIL FIRST, TWO
 THOUSAND TWENTY-THREE THROUGH MARCH THIRTIETH, TWO THOUSAND TWENTY-FOUR,
 FOR ALL GENERAL HOSPITALS IN THE REGION APPLICABLE TO  SPECIFIED  THIRD-
 PARTY  PAYORS, AND APPLICABLE TO RELATED PATIENT COINSURANCE AND DEDUCT-
 IBLE AMOUNTS, SHALL BE THE SAME REGIONAL PERCENTAGE ALLOWANCE CALCULATED
 PURSUANT TO PARAGRAPH (B) OF THIS SUBDIVISION  FOR  THE  PERIOD  JANUARY
 FIRST, NINETEEN HUNDRED NINETY-NINE THROUGH DECEMBER THIRTY-FIRST, NINE-
 TEEN  HUNDRED  NINETY-NINE  MULTIPLIED  BY SEVENTY-THREE AND TWENTY-NINE
 HUNDREDTHS PERCENT.
   (VII) THE REGIONAL PERCENTAGE ALLOWANCE FOR PERIODS APRIL  FIRST,  TWO
 THOUSAND  TWENTY-FOUR THROUGH MARCH THIRTIETH, TWO THOUSAND TWENTY-FIVE,
 FOR ALL GENERAL HOSPITALS IN THE REGION APPLICABLE TO  SPECIFIED  THIRD-
 PARTY  PAYORS, AND APPLICABLE TO RELATED PATIENT COINSURANCE AND DEDUCT-
 IBLE AMOUNTS, SHALL BE THE SAME REGIONAL PERCENTAGE ALLOWANCE CALCULATED

 A. 4911                             8

 PURSUANT TO PARAGRAPH (B) OF THIS SUBDIVISION  FOR  THE  PERIOD  JANUARY
 FIRST, NINETEEN HUNDRED NINETY-NINE THROUGH DECEMBER THIRTY-FIRST, NINE-
 TEEN  HUNDRED  NINETY-NINE  MULTIPLIED  BY  FORTY-EIGHT  AND  EIGHTY-SIX
 HUNDREDTHS PERCENT.
   (VIII)  THE REGIONAL PERCENTAGE ALLOWANCE FOR PERIODS APRIL FIRST, TWO
 THOUSAND TWENTY-FIVE THROUGH MARCH THIRTIETH, TWO  THOUSAND  TWENTY-SIX,
 FOR  ALL  GENERAL HOSPITALS IN THE REGION APPLICABLE TO SPECIFIED THIRD-
 PARTY PAYORS, AND APPLICABLE TO RELATED PATIENT COINSURANCE AND  DEDUCT-
 IBLE AMOUNTS, SHALL BE THE SAME REGIONAL PERCENTAGE ALLOWANCE CALCULATED
 PURSUANT  TO  PARAGRAPH  (B)  OF THIS SUBDIVISION FOR THE PERIOD JANUARY
 FIRST, NINETEEN HUNDRED NINETY-NINE THROUGH DECEMBER THIRTY-FIRST, NINE-
 TEEN HUNDRED  NINETY-NINE  MULTIPLIED  BY  TWENTY-FOUR  AND  FORTY-THREE
 HUNDREDTHS PERCENT.
   §  7.  This act shall take effect immediately; provided, however, that
 the amendments to section 2807-j  of  the  public  health  law  made  by
 section five of this act shall not affect the expiration of such section
 and shall be deemed to expire therewith; provided further, however, that
 the  amendments  to  section  2807-s  of  the  public health law made by
 section six of this act shall not affect the expiration of such  section
 and shall be deemed to expire therewith.