§ 16-21-10-8 — Authorization for development of program to increase Medicaid reimbursement for hospital services; submission of report to budget committee before submitting state plan amendments or waivers; state share dollars; termination of program

Indiana § 16-21-10-8

• Jurisdiction: Indiana
• Title 16: HEALTH
• Art. 21: HOSPITALS
• Ch. 10: Hospital Assessment Fee

Text

(a) This section does not apply to the use of
the incremental fee described in section 13.3 of this chapter. Subject to
subsection (b), the office may develop the following programs designed
to increase Medicaid reimbursement for inpatient and outpatient
hospital services provided by a hospital to Medicaid recipients:
(1) A program concerning reimbursement for the Medicaid
fee-for-service program that, in the aggregate, will result in
payments equivalent to the level of payment that would be paid
under federal Medicare payment principles.
(2) A program concerning reimbursement for the Medicaid risk
based managed care program that, in the aggregate, will result in
payments equivalent to the level of payment that would be paid
under federal Medicare payment principles, and up to any
reimbursement approved under a state directed payment program
set forth in section 8.5 of this chapter.
(b) The office shall not submit to the United States Department of
Health and Human Services any Medicaid state plan amendments,
waiver requests, or revisions to any Medicaid state plan amendments
or waiver requests, to implement or continue the implementation of this
chapter until the office has submitted a written report to the budget
committee concerning the amendments, waivers, or revisions described
in this subsection, including the following:
(1) The methodology to be used by the office in calculating the
increased Medicaid reimbursement under the programs described
in subsection (a).
(2) The methodology to be used by the office in calculating,
imposing, or collecting the fee, or any other matter relating to the
fee.
(3) The determination of Medicaid disproportionate share
allotments under section 11 of this chapter (subject to section
11(d) and 11(e) of this chapter) that are to be funded by the fee,
including the formula for distributing the Medicaid
disproportionate share allotments.
(4) The distribution to private psychiatric institutions under
section 13 of this chapter.
(c) This subsection applies to the programs described in subsection
(a). The state share dollars for the programs must consist of the
following:
(1) Fees paid under this chapter.
(2) The hospital care for the indigent funds allocated under
section 10 of this chapter.
(3) Other sources of state share dollars available to the office,
excluding intergovernmental transfers of funds made by or on
behalf of a hospital.
The money described in subdivisions (1) and (2) may be used only to
fund the part of the payments that exceed the Medicaid reimbursement
rates in effect on June 30, 2011.
(d) This subsection applies to the programs described in subsection
(a). If the state is unable to maintain the funding under subsection
(c)(3) for the payments at Medicaid reimbursement levels in effect on
June 30, 2011, because of budgetary constraints, the office shall reduce
inpatient and outpatient hospital Medicaid reimbursement rates under
subsection (a)(1) or (a)(2) or request approval from the United States
Department of Health and Human Services to increase the fee to
prevent a decrease in Medicaid reimbursement for hospital services. If
the United States Department of Health and Human Services does not
approve an increase in the fee, the office shall cease to collect the fee
and the programs described in subsection (a) are terminated.

Legislative History

As added by P.L.205-2013, SEC.214. Amended by P.L.213-2015, SEC.143; P.L.216-2025, SEC.25.