Indiana § 12-15-19-2.1 Disproportionate share payment methodology for state fiscal years
ending on or after June 30, 2000; limits on total disproportionate share
payments to hospitals

Indiana Statutes

§ 12-15-19-2.1 — Disproportionate share payment methodology for state fiscal years ending on or after June 30, 2000; limits on total disproportionate share payments to hospitals

Indiana § 12-15-19-2.1

Art. 15MEDICAID

Ch. 19Disproportionate Share Providers; Enhanced

This text of Indiana § 12-15-19-2.1 (Disproportionate share payment methodology for state fiscal years ending on or after June 30, 2000; limits on total disproportionate share 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 § 12-15-19-2.1 (2026).

Text

1.

(a)This section does not apply during the period that the office is assessing a hospital fee authorized by IC 16-21-10. For each state fiscal year ending on or after June 30, 2000, the office shall develop a disproportionate share payment methodology that ensures that each hospital qualifying for disproportionate share payments under IC 12-15-16-1(a) timely receives total disproportionate share payments that do not exceed the hospital's hospital specific limit provided under 42 U.S.C. 1396r-4(g). The payment methodology as developed by the office must:

(1)maximize disproportionate share hospital payments to qualifying hospitals to the extent practicable;

(2)take into account the situation of those qualifying hospitals that have historically qualified for Medicaid disproportionate sha

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1. (a) This section does not apply during the
period that the office is assessing a hospital fee authorized by IC 16-21-10. For each state fiscal year ending on or after June 30, 2000,
the office shall develop a disproportionate share payment methodology
that ensures that each hospital qualifying for disproportionate share
payments under IC 12-15-16-1(a) timely receives total disproportionate
share payments that do not exceed the hospital's hospital specific limit
provided under 42 U.S.C. 1396r-4(g). The payment methodology as
developed by the office must:
(1) maximize disproportionate share hospital payments to
qualifying hospitals to the extent practicable;
(2) take into account the situation of those qualifying hospitals
that have historically qualified for Medicaid disproportionate
share payments; and
(3) ensure that payments for qualifying hospitals are equitable.
(b) Total disproportionate share payments to a hospital under this
chapter shall not exceed the hospital specific limit provided under 42
U.S.C. 1396r-4(g). The hospital specific limit for a state fiscal year
shall be determined by the office taking into account data provided by
each hospital that is considered reliable by the office based on a system
of periodic audits, the use of trending factors, and an appropriate base
year determined by the office. The office may require independent
certification of data provided by a hospital to determine the hospital's
hospital specific limit.
(c) The office shall include a provision in each amendment to the
state plan regarding Medicaid 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 after the end of
each federal fiscal year that relate back to a prior federal fiscal year.
However, the total disproportionate share payments to:
(1) each individual hospital; and
(2) all qualifying hospitals in the aggregate;
may not exceed the limits provided by federal law and regulation.

Legislative History

As added by P.L.113-2000, SEC.12. Amended by P.L.283-2001, SEC.24; P.L.66-2002, SEC.10; P.L.212-2007, SEC.8; P.L.218-2007, SEC.18; P.L.229-2011, SEC.136; P.L.205-2013, SEC.199.