ARTICLE
12 AS AMENDED
RELATING TO
HOSPITAL UNCOMPENSATED CARE
SECTION 1. Sections 40-8.3-2 and 40-8.3-3 of the General
Laws in Chapter 40-8.3
entitled "Uncompensated Care" are hereby amended to
read as follows:
40-8.3-2.
Definitions. -- As used in this chapter:
(1) "Base
year" means for the purpose of calculating a disproportionate share
payment for
any fiscal year ending after September 30, 2011 2012,
the period from October 1, 2009 2010
through September 30, 2010 2011, and for any
fiscal year ending after September 30, 2012 2013,
the period from October 1, 2010 2011
through September 30, 20112012.
(2) "Medical
assistance inpatient utilization rate for a hospital" means a fraction
(expressed as a percentage)
the numerator of which is the hospital's number of inpatient days
during the base year attributable to patients who were
eligible for medical assistance during the
base year and the denominator of which is the total number
of the hospital's inpatient days in the
base year.
(3) "Participating
hospital" means any nongovernment and nonpsychiatric
hospital that:
(i) was
licensed as a hospital in accordance with chapter 17 of title 23 during the
base year; (ii)
achieved a medical assistance inpatient utilization rate of at
least one percent (1%) during the
base year; and (iii) continues to be licensed as a
hospital in accordance with chapter 17 of title 23
during the payment year.
(4) "Uncompensated
care costs" means, as to any hospital, the sum of: (i)
the cost
incurred by such hospital during the base year for inpatient
or outpatient services attributable to
charity care (free care and bad debts) for which the patient
has no health insurance or other third-
party coverage less payments, if any, received directly
from such patients; and (ii) the cost
incurred by such hospital during the base year for inpatient
or out-patient services attributable to
Medicaid beneficiaries less any Medicaid reimbursement
received therefor; multiplied by the
uncompensated care index.
(5) "Uncompensated
care index" means the annual percentage increase for hospitals
established pursuant to § 27-19-14 for each year after the base
year, up to and including the
payment year, provided, however, that the uncompensated care
index for the payment year ending
September 30, 2007 shall be deemed to be five and
thirty-eight hundredths percent (5.38%), and
that the uncompensated care index for the payment year
ending September 30, 2008 shall be
deemed to be five and forty-seven hundredths percent
(5.47%), and that the uncompensated care
index for the payment year ending September 30, 2009 shall
be deemed to be five and thirty-eight
hundredths percent (5.38%), and that the uncompensated care
index for the payment years ending
September 30, 2010, September 30, 2011, September 30,
2012 and, September 30, 2013 and
September 30, 2014 shall be deemed to be five and thirty hundredths percent (5.30%).
40-8.3-3.
Implementation. -- (a) For
the fiscal year commencing on October 1, 2010 and
ending September 30, 2011, the department of human services
shall submit to the Secretary of the
U.S. Department of Health and Human Services a state
plan amendment to the
Medicaid state plan for disproportionate share
hospital payments (DSH Plan) to provide:
(1) That the
disproportionate share hospital payments to all participating hospitals not to
exceed an aggregate limit of $125.4 million, to be allocated
by the department to the Pool A, Pool
C and Pool D components of the DSH Plan;
(2) That the Pool D
allotment shall be distributed among the participating hospitals in
direct proportion to the individual participating hospital's
uncompensated care costs for the base
year, inflated by the uncompensated care index to the
total uncompensated care costs for the base
year inflated by uncompensated care index for all
participating hospitals. The disproportionate
share payments shall be made on or before July 18, 2011 and
are expressly conditioned upon
approval on or before July 11, 2011 by the Secretary of the
U.S. Department of Health and
Human Services, or his or her authorized
representative, of all Medicaid state plan amendments
necessary to secure for the state the benefit of federal
financial participation in federal fiscal year
2011 for the disproportionate
share payments.
(b)(a) For
the fiscal year commencing on October 1, 2011 and ending September 30,
2012, the executive office of health and human
services shall submit to the Secretary of the
Department of Health and Human Services a state plan
amendment to the Rhode Island Medicaid
state plan for disproportionate share hospital payments
(DSH Plan) to provide:
(1) That the
disproportionate share hospital payments to all participating hospitals, not to
exceed an aggregate limit of $126.2 million, shall be
allocated by the executive office of health
and human services to the Pool A, Pool C and Pool D
components of the DSH Plan; and,
(2) That the Pool D
allotment shall be distributed among the participating hospitals in
direct proportion to the individual participating hospital's
uncompensated care costs for the base
year, inflated by the uncompensated care index to the
total uncompensated care costs for the base
year inflated by uncompensated care index for all
participating hospitals. The disproportionate
share payments shall be made on or before July 16, 2012 and
are expressly conditioned upon
approval on or before July 9, 2012 by the Secretary of the
U.S. Department of Health and Human
Services, or his or her authorized representative, of
all Medicaid state plan amendments necessary
to secure for the state the benefit of federal financial
participation in federal fiscal year 2012 for
the disproportionate share payments.
(c)(b) For
federal fiscal year 2013, commencing on October 1, 2012 and ending
September 30, 2013, the executive office of health and
human services shall submit to the
Secretary of the U.S. Department of Health and Human
Services a state plan amendment to the
Rhode Island Medicaid state plan for disproportionate
share hospital payments (DSH Plan) to
provide:
(1) That the
disproportionate share hospital payments to all participating hospitals, not to
exceed an aggregate limit of $128.3 million, shall be
allocated by the executive office of health
and human services to the Pool A, Pool C and Pool D
components of the DSH Plan; and,
(2) That the Pool D
allotment shall be distributed among the participating hospitals in
direct proportion to the individual participating hospital's
uncompensated care costs for the base
year, inflated by the uncompensated care index to the
total uncompensated care costs for the base
year inflated by uncompensated care index for all
participating hospitals. The disproportionate
share payments shall be made on or before July 15, 2013 and
are expressly conditioned upon
approval on or before July 8, 2013 by the Secretary of the
U.S. Department of Health and Human
Services, or his or her authorized representative, of
all Medicaid state plan amendments necessary
to secure for the state the benefit of federal financial
participation in federal fiscal year 2013 for
the disproportionate share payments.
(c) For federal
fiscal year 2014, commencing on October 1, 2013 and ending September
30, 2014, the executive office of health and human
services shall submit to the Secretary of the
Medicaid state plan for disproportionate share
hospital payments (DSH Plan) to provide:
(1) That the
disproportionate share hospital payments to all participating hospitals, not to
exceed an aggregate limit of $128.3 million, shall be allocated
by the executive office of health
and human services to the Pool A, Pool C and Pool D
components of the DSH Plan; and,
(2) That the Pool D
allotment shall be distributed among the participating hospitals in
direct proportion to the individual participating hospital's
uncompensated care costs for the base
year, inflated by the uncompensated care index to the
total uncompensated care costs for the base
year inflated by uncompensated care index for all
participating hospitals. The disproportionate
share payments shall be made on or before July 14, 2014 and
are expressly conditioned upon
approval on or before July 7, 2014 by the Secretary of the
Services, or his or her authorized representative, of
all Medicaid state plan amendments necessary
to secure for the state the benefit of federal financial
participation in federal fiscal year 2014 for
the disproportionate share payments.
(d) No provision is made
pursuant to this chapter for disproportionate share hospital
payments to participating hospitals for uncompensated care
costs related to graduate medical
education programs.
SECTION 2. This article shall take effect upon passage.