§ 12-15-19-8 — Disproportionate share adjustments received by municipal disproportionate share providers; limits on total disproportionate share payments

Indiana § 12-15-19-8

• Jurisdiction: Indiana
• Art. 15: MEDICAID
• Ch. 19: Disproportionate Share Providers; Enhanced

Text

(a) This section does not apply during the
period that the office is assessing a hospital fee authorized by IC 16-21-10. A provider that qualifies as a municipal disproportionate
share provider under IC 12-15-16-1 shall receive a disproportionate
share adjustment, subject to the provider's hospital specific limits
described in subsection (b), as follows:
(1) For each state fiscal year ending on or after June 30, 1998, an
amount shall be distributed to each provider qualifying as a
municipal disproportionate share provider under IC 12-15-16-1.
The total amount distributed shall not exceed the sum of all
hospital specific limits for all qualifying providers.
(2) For each municipal disproportionate share provider qualifying
under IC 12-15-16-1 to receive disproportionate share payments,
the amount in subdivision (1) shall be reduced by the amount of
disproportionate share payments received by the provider under
IC 12-15-16-6 or sections 1 or 2.1 of this chapter. The office shall
develop a disproportionate share provider payment methodology
that ensures that each municipal disproportionate share provider
receives disproportionate share payments that do not exceed the
provider's hospital specific limit specified in subsection (b). The
methodology developed by the office shall ensure that a
municipal disproportionate share provider receives, to the extent
possible, disproportionate share payments that, when combined
with any other disproportionate share payments owed to the
provider, equals the provider's hospital specific limits.
(b) Total disproportionate share payments to a provider 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 data provided by each
hospital for the hospital's most recent fiscal year or, if a change in fiscal
year causes the most recent fiscal period to be less than twelve (12)
months, twelve (12) months of data compiled to the end of the
provider's fiscal year that ends within the most recent state fiscal year,
as certified to the office by an independent certified public accounting
firm. The hospital specific limit for all state fiscal years ending on or
after June 30, 2000, shall be determined by the office taking into
account data provided by each hospital that is deemed 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) For each of the state fiscal years:
(1) beginning July 1, 1998, and ending June 30, 1999; and
(2) beginning July 1, 1999, and ending June 30, 2000;
the total municipal disproportionate share payments available under
this section to qualifying municipal disproportionate share providers is
twenty-two million dollars ($22,000,000).

Legislative History

As added by P.L.126-1998, SEC.12. Amended by P.L.113-2000, SEC.15; P.L.229-2011, SEC.138; P.L.205-2013, SEC.201.