Section 148.85  Supplemental Tertiary Care Adjustment Payments

a)         Qualifying Criteria.  Supplemental Tertiary Care Adjustment Payments, as described in subsection (b) of this Section, shall be made to all qualifying Illinois hospitals.  An Illinois hospital shall qualify for payment if it was deemed eligible for payments under the Tertiary Care Adjustment Payments for State fiscal year 2003, as described in Section 148.296, excluding:

1)         County-owned hospitals as described in Section 148.25(b)(1)(A).

2)         Hospitals organized under the University of Illinois Hospital Act [110 ILCS 330], as described in Section 148.25(b)(1)(B).

3)         A hospital owned or operated by a State agency, as described in Section 148.25(b)(6).

b)         Supplemental Tertiary Care Adjustment Payments

1)         For the supplemental tertiary care adjustment period occurring in State fiscal year 2004, total payments will equal the State fiscal year 2003 tertiary care adjustment payment, as defined in Section 148.296, multiplied by the proration factor and shall be paid to the hospital within 75 days after the conditions described in subsection (d) of this Section have been met.

2)         For the supplemental tertiary care adjustment period occurring in State fiscal year 2005, total payments will equal the State fiscal year 2003 tertiary care adjustment payment, as defined in Section 148.296 and shall be paid to the hospital in four equal installments on or before July 15, 2004, October 15, 2004, January 14, 2005 and April 15, 2005.  The sum of the amounts, required prior to the conditions described in subsection (d) being met, shall be paid within 75 days after the conditions described in subsection (d) have been met.

3)         If a hospital closes during the fiscal year, payments will be prorated based on the number of days the hospital was open during the fiscal year.

c)         Definitions

1)         "Proration factor" means a fraction, the numerator of which is 53 and the denominator of which is 365.

2)        "Supplemental Tertiary Care Adjustment Period" means, beginning June 1, 2004, the one month period beginning on June 1, 2004 and ending June 30, 2004, and beginning July 1, 2004, the 12-month period beginning July 1 of the year and ending June 30 of the following year.

d)         Payment Limitations:  Payments under this Section are not due and payable until:

1)         the methodologies described in this Section receive federal approval from the Centers for Medicare and Medicaid Services in an appropriate State Plan Amendment;

2)         the assessment imposed under 89 Ill. Adm. Code 140.80 is determined to be a permissible tax under Title XIX of the Social Security Act; and

3)         the assessment described in 89 Ill. Adm. Code 140.80 is in effect.

(Source:  Amended at 29 Ill. Reg. 8363, effective June 1, 2005)