Indiana § 12-15-15-1.6 Alternative payment methodology for payments to hospitals

Indiana Statutes

§ 12-15-15-1.6 — Alternative payment methodology for payments to hospitals

Indiana § 12-15-15-1.6

Art. 15MEDICAID

Ch. 15Payment to Hospitals; General

This text of Indiana § 12-15-15-1.6 (Alternative payment methodology for payments to hospitals) is published on Counsel Stack Legal Research, covering Indiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Ind. Code § 12-15-15-1.6 (2026).

Text

6.

(a)This section applies only if the office determines, based on information received from the United States Centers for Medicare and Medicaid Services, that payments made under section 1.5(b) STEP FIVE (A), (B), or (C) of this chapter will not be approved for federal financial participation. This section does not apply during the period that the office is assessing a hospital fee authorized by IC 16-21-10.

(b)If the office determines that payments made under section 1.5(b) STEP FIVE (A) of this chapter will not be approved for federal financial participation, the office may make alternative payments to payments under section 1.5(b) STEP FIVE (A) of this chapter if:

(1)the payments for a state fiscal year are made only to a hospital that would have been eligible for a payment for that

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6. (a) This section applies only if the office
determines, based on information received from the United States
Centers for Medicare and Medicaid Services, that payments made
under section 1.5(b) STEP FIVE (A), (B), or (C) of this chapter will not
be approved for federal financial participation. This section does not
apply during the period that the office is assessing a hospital fee
authorized by IC 16-21-10.
(b) If the office determines that payments made under section 1.5(b)
STEP FIVE (A) of this chapter will not be approved for federal
financial participation, the office may make alternative payments to
payments under section 1.5(b) STEP FIVE (A) of this chapter if:
(1) the payments for a state fiscal year are made only to a hospital
that would have been eligible for a payment for that state fiscal
year under section 1.5(b) STEP FIVE (A) of this chapter; and
(2) the payments for a state fiscal year to each hospital are an
amount that is as equal as possible to the amount each hospital
would have received under section 1.5(b) STEP FIVE (A) of this
chapter for that state fiscal year.
(c) If the office determines that payments made under section 1.5(b)
STEP FIVE (B) of this chapter will not be approved for federal
financial participation, the office may make alternative payments to
payments under section 1.5(b) STEP FIVE (B) of this chapter if:
(1) the payments for a state fiscal year are made only to a hospital
that would have been eligible for a payment for that state fiscal
year under section 1.5(b) STEP FIVE (B) of this chapter; and
(2) the payments for a state fiscal year to each hospital are an
amount that is as equal as possible to the amount each hospital
would have received under section 1.5(b) STEP FIVE (B) of this
chapter for that state fiscal year.
(d) If the office determines that payments made under section 1.5(b)
STEP FIVE (C) of this chapter will not be approved for federal
financial participation, the office may make alternative payments to
payments under section 1.5(b) STEP FIVE (C) of this chapter if:
(1) the payments for a state fiscal year are made only to a hospital
that would have been eligible for a payment for that state fiscal
year under section 1.5(b) STEP FIVE (C) of this chapter; and
(2) the payments for a state fiscal year to each hospital are an
amount that is as equal as possible to the amount each hospital
would have received under section 1.5(b) STEP FIVE (C) of this
chapter for that state fiscal year.
(e) If the office determines, based on information received from the
United States Centers for Medicare and Medicaid Services, that
payments made under subsection (b), (c), or (d) will not be approved
for federal financial participation, the office shall use the funds that
would have served as the nonfederal share of these payments for a state
fiscal year to serve as the nonfederal share of a payment program for
hospitals to be established by the office. The payment program must
distribute payments to hospitals for a state fiscal year based upon a
methodology determined by the office to be equitable under the
circumstances.