Medicare certified long-term acute care hospitals; exempt from the hospital provider assessment subject to approval by CMS.

Exemption criteria for Medicare-certified long-term acute care hospitals now explicitly require CMS approval and must not result in the state receiving a lower federal financial participation rate for any supplemental payment program.

Removed language that broadly exempted Medicare-certified long-term acute care hospitals from the assessment without specifying CMS approval requirements or federal funding impact conditions.

New subsection (ef) was added to clarify that exemptions for long-term acute care hospitals are at the discretion of the division and subject to CMS approval with federal funding safeguards.

The act title was updated to reflect the new conditional nature of exemptions, emphasizing the protection of federal financial participation rates.