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HHP-101 Hospital Provider User Fee

General Instructions

Each hospital must use form HHP-101, Hospital Provider User Fee, to electronically file and pay the quarterly fee imposed on net revenue from inpatient hospital services and outpatient hospital services.

Line 1: Enter one quarter of the audited net revenue from inpatient hospital services for federal fiscal year 2016. This is the amount listed on the Second Hospital User Fee - Notice of Revised Audited Net Revenue sent to each hospital.

Line 4: Multiply the amount on Line 1 by 6%. Enter the Inpatient Hospital User Fee due.

Line 5: Enter one quarter of the audited net revenue from outpatient hospital services for federal fiscal year 2016. This is the amount listed on the Second Hospital User Fee - Notice of Revised Audited Net Revenue sent to each hospital.

Line 8: Multiply the amount on Line 5 by the fee rate imposed on net revenue from outpatient hospital services. PublicActs 17-4 (June Spec. Sess.), ยง 2 sets the fee rate for the provision of outpatient hospital services at $900,000,000 less the total inpatient hospital user fee from all hospitals divided by the total audited net outpatient hospital revenue from all hospitals. The total inpatient hospital user fee is $305,527,677. The total audited net outpatient hospital revenue is $4,820,354,880. As such, under the formula prescribed by law, the fee rate for the provision of outpatient hospital services is 12.3325%. Enter the Outpatient Hospital User Fee due.

Line 11: Is the calculated total amount due and needs to be paid by the due date.