(a)For the state fiscal years ending on June
30, 1998, and June 30, 1999, the office shall develop an enhanced
disproportionate share payment methodology that ensures that each
enhanced disproportionate share provider receives total
disproportionate share payments that do not exceed its hospital specific
limit specified in subsection (c). The methodology developed by the
office shall ensure that hospitals operated by or affiliated with the
governmental entities described in IC 12-15-18-5.1(a) receive, to the
extent practicable, disproportionate share payments equal to their
hospital specific limits. The funds shall be distributed to qualifying
hospitals in proportion to each qualifying hospital's percentage of the
total net hospital specific limits of all qualifying hospitals. A hospital'
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(a) For the state fiscal years ending on June
30, 1998, and June 30, 1999, the office shall develop an enhanced
disproportionate share payment methodology that ensures that each
enhanced disproportionate share provider receives total
disproportionate share payments that do not exceed its hospital specific
limit specified in subsection (c). The methodology developed by the
office shall ensure that hospitals operated by or affiliated with the
governmental entities described in IC 12-15-18-5.1(a) receive, to the
extent practicable, disproportionate share payments equal to their
hospital specific limits. The funds shall be distributed to qualifying
hospitals in proportion to each qualifying hospital's percentage of the
total net hospital specific limits of all qualifying hospitals. A hospital's
net hospital specific limit for state fiscal years ending on or before June
30, 1999, is determined under STEP THREE of the following formula:
STEP ONE: Determine the hospital's hospital specific limit under
subsection (c).
STEP TWO: Subtract basic disproportionate share payments
received by the hospital under IC 12-15-16-6 from the amount
determined under STEP ONE.
STEP THREE: Subtract intergovernmental transfers paid by or on
behalf of the hospital from the amount determined under STEP
TWO.
(b) The office shall include a provision in each amendment to the
state plan regarding disproportionate share payments, municipal
disproportionate share payments, and community mental health center
disproportionate share payments that the office submits to the federal
Centers for Medicare and Medicaid Services that, as provided in 42
CFR 447.297(d)(3), allows the state to make additional
disproportionate share expenditures, municipal disproportionate share
expenditures, and community mental health center disproportionate
share expenditures after the end of each federal fiscal year that relate
back to a prior federal fiscal year. Each eligible hospital or community
mental health center may receive an additional disproportionate share
adjustment if:
(1) additional intergovernmental transfers or certifications are
made as authorized under IC 12-15-18-5.1; and
(2) the total disproportionate share payments to:
(A) each individual hospital; and
(B) all qualifying hospitals in the aggregate;
do not exceed the limits provided by federal law and regulation.
(c) For state fiscal years ending on or before June 30, 1999, total
basic and enhanced disproportionate share payments to a hospital
under this chapter and IC 12-15-16 shall not exceed the hospital
specific limit provided under 42 U.S.C. 1396r-4(g). The hospital
specific limit for state fiscal years ending on or before June 30, 1999,
shall be determined by the office taking into account any data provided
by each hospital for each hospital's most recent fiscal year (or in cases
where a change in fiscal year causes the most recent fiscal period to be
less than twelve (12) months, twelve (12) months of data ending at the
end of the most recent fiscal year) as certified to the office by:
(1) an independent certified public accounting firm if the hospital
is a hospital licensed under IC 16-21 that qualifies under IC 12-15-16-1(a); or
(2) the budget agency if the hospital is a state mental health
institution listed under IC 12-24-1-3 that qualifies under either IC 12-15-16-1(a)(1) or IC 12-15-16-1(a)(2);
in accordance with this subsection and federal laws, regulations, and
guidelines. The hospital specific limit for state fiscal years ending after
June 30, 1999, shall be determined by the office using the methodology
described in section 2.1(b) of this chapter.
[Pre-1992 Revision Citation: 12-1-7-17.8(a).]
Indiana § 12-15-19-1 (Enhanced disproportionate share payment methodology for state fiscal
years ending June 30, 1998, and June 30, 1999; limits on basic and
enhanced disproportionate share payments to hospitals) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.