Page:United States Statutes at Large Volume 105 Part 2.djvu/844

 105 STAT. 1796 PUBLIC LAW 102-234—DEC. 12, 1991 "(C)(i) Subject to clause (ii), for purposes of subparagraph (B)(ii), a tax is considered to be imposed uniformly if— "(I) in the case of a tax consisting of a licensing fee or similar tax oh a class of health care items or services (or providers of such items or services), the amount of the tax imposed is the same for every provider providing items or services within the "(II) in the case of a tax consisting of a licensing fee or similar tax imposed on a class of health care items or services (or providers of such services) on the basis of the number of beds (licensed or otherwise) of the provider, the amount of the tax is the same for each bed of each provider of such items or services in the class; "(III) in the case of a tax based on revenues or receipts with respect to a class of items or services (or providers of items or services) the tax is imposed at a uniform rate for all items and services (or providers of such items or services) in the class on all the gross revenues or receipts, or net operating revenues, relating to the provision of all such items or services (or all such providers) in the State (or, in the case of a tax imposed by a unit of local government within the State, in the area over which the unit has jurisdiction); or "(IV) in the case of any other tax, the State establishes to the satisfaction of the Secretary that the tax is imposed uniformly, "(ii) Subject to subparagraphs (D) and (E), a tax imposed with respect to a class of health care items and services is not considered to be imposed uniformly if the tax provides for any credits, exclusions, or deductions which have as their purpose or effect the return to providers of all or a portion of the tax paid in a manner that is inconsistent with subclauses (I) and (II) of subparagraph (E)(ii) or provides for a hold harmless provision described in paragraph (4). "(D) A tax imposed with respect to a class of health care items and services is considered to be imposed uniformly— "(i) notwithstanding that the tax is not imposed with respect to items or services (or the providers thereof) for which payment is made under a State plan under this title or title XVIII, or "(ii) in the case of a tax described in subparagraph (C)(i)(III), notwithstanding that the tax provides for exclusion (in whole or in part) of revenues or receipts from a State plan under this title or title XVIII. "(E)(i) A State may submit an application to the Secretary requesting that the Secretary treat a t«ix as a broad-based health care related tax, notwithstanding that the tax does not apply to all health care items or services in class (or all providers of such items and services), provides for a credit, deduction, or exclusion, is not applied uniformly, or otherwise does not meet the requirements of subparagraph (B) or (C). Permissible waivers may include exemptions for rural or sole-community providers. "(ii) The Secretary shall approve such an application if the State establishes to the satisfaction of the Secretary that— "(I) the net impact of the tax and associated expenditures under this title as proposed by the State is generally redistributive in nature, and "(II) the amount of the tax is not directly correlated to payments under this title for items or services with respect to which the tax is imposed.

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