7d51c4d1_Questions_and_Answers__Question
[Question Number] 2 [Answer] For dates of service prior to April 1, 2012, payments made to HCRA designated providers by governmental agencies from other states, including out-of-state Medicaid programs, were fully subject to the HCRA surcharges at rates based on their election status. For dates of service April 1, 2012 and forward, out-of-state Medicaid programs are considered Unspecified Payors, and subject to the Unspecified Payor/Self-Pay surcharge rate, when billed by the provider, but no covered lives or regional GME percentage surcharge. Providers are to ignore the Elector List with regards to electing states and their Medicaid program and assess the Unspecified Payor/Self-Pay surcharge rate on all bills to the out-of-state Medicaid program. Please note, out-of-state governmental programs with inpatient coverage are not obligated to a covered lives assessment (if an elector) or the regional GME percentage (if a non-elector) unless the program is making payments to providers in its role as an employer for its employees. In this instance, the out-of-state governmental program would have a covered lives obligation for those insured whose primary insured's legal residence is within New York State, or, would have a regional GME percentage obligation if a non-elector, when billed. Other out-of-state governmental programs are not affected by this April 1, 2012 decision, and must make an election in order to be obligated to the reduced surcharge percentage. [Question] 
Clarify how the surcharges apply to out-of-state governmental programs.
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