Section 148.175  Supplemental Disproportionate Share Payment Methodology for Hospitals Organized Under the Town Hospital Act

a)         The Department shall make supplemental disproportionate share (DSH) payments in accordance with this Section to hospitals that meet all of the following requirements:

1)         Qualify for DSH payment adjustments in accordance with Section 148.120(a).

2)         Are organized under the Town Hospital Act [60 ILCS 170].

3)         Have entered into an agreement, approved by the Director.

b)         Review Procedure

The review procedure shall be in accordance with Section 148.310.

c)         Applicable Adjustments for Disproportionate Share Hospitals (DSH)

1)         The criteria and methodology for making applicable adjustments to government owned DSH hospitals as described in subsection (a) above, shall be in accordance with Section 148.120.

2)         Effective with dates of service on or after May 12, 1995, in addition to the DSH payment adjustments described in Section 148.120, hospitals reimbursed under this Section shall be eligible for supplemental DSH payments.  Effective with admissions on or after May 12, 1995, supplemental DSH payments for hospitals reimbursed under this Section shall be calculated by multiplying the sum of the hospital's alternate cost per diem rate in effect on May 12, 1995, as described in Sections 148.260, 148.270, and 89 Ill. Adm. Code 152.200, and the calculated disproportionate share per diem payment adjustment in effect on May 12, 1995, as described in Section 148.120, by the hospital's percentage of charges which are not reimbursed by a third party payor for the period of August 1, 1991 through July 31, 1992.  The resulting product shall be multiplied by 6.25 and this amount shall be the supplemental DSH payment adjustment which shall be paid on a per diem basis and shall be applied to each covered day of care provided.  The supplemental DSH payments cannot exceed the amount the hospital certifies as costs eligible for Federal Financial Participation under Title XIX of the Social Security Act.

3)         DSH adjustments made under this subsection are subject to the DSH adjustment limitations described in Section 148.120(j).

d)         Rate Period

The rate period for hospitals reimbursed under this Section shall be the 12 month period beginning on October 1 of the year and ending September 30 of the following year, except for the period of May 12, 1995 through September 30, 1995.

(Source:  Added at 19 Ill. Reg. 13009, effective September 5, 1995)