Indiana § 12-15-16-3 Low income utilization rate; contractual allowances and discounts

Indiana Statutes

§ 12-15-16-3 — Low income utilization rate; contractual allowances and discounts

Indiana·Art. 15 MEDICAID·Ch. 16 Disproportionate Share Providers; Eligibility

(a)For purposes of disproportionate share eligibility, a provider's low income utilization rate is the sum of the following, based on the most recent year for which an audited cost report is on file with the office:

(1)A fraction (expressed as a percentage) for which:

(A)the numerator is the sum of:

(i)the total Medicaid patient revenues paid to the provider; plus

(ii)the amount of the cash subsidies received directly from state and local governments, including payments made under the hospital care for the indigent program (IC 12-16-2) (before its repeal) and IC 12-16-2.5; and

(B)the denominator is the total amount of the provider's patient revenues paid to the provider, including cash subsidies; and

(2)A fraction (expressed as a percentage) for which:

(A)the numerator is the total

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(a) For purposes of disproportionate share
eligibility, a provider's low income utilization rate is the sum of the
following, based on the most recent year for which an audited cost
report is on file with the office:
(1) A fraction (expressed as a percentage) for which:
(A) the numerator is the sum of:
(i) the total Medicaid patient revenues paid to the provider;
plus
(ii) the amount of the cash subsidies received directly from
state and local governments, including payments made under
the hospital care for the indigent program (IC 12-16-2)
(before its repeal) and IC 12-16-2.5; and
(B) the denominator is the total amount of the provider's patient
revenues paid to the provider, including cash subsidies; and
(2) A fraction (expressed as a percentage) for which:
(A) the numerator is the total amount of the provider's charges
for inpatient services that are attributable to care provided to
individuals who have no source of payment; and
(B) the denominator is the total amount of charges for inpatient
services.
(b) The numerator in subsection (a)(1)(A) does not include
contractual allowances and discounts other than for indigent patients
not eligible for Medicaid.
[Pre-1992 Revision Citation: 12-1-7-60(c).]

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