TITLE 40
Human services

CHAPTER 40-8.3
Uncompensated Care

SECTION 40-8.3-3


§ 40-8.3-3 Implementation.

(a) For federal fiscal year 2015, commencing on October 1, 2014, and ending September 30, 2015, 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 DSH Plan to all participating hospitals, not to exceed an aggregate limit of $140.0 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 DSH Plan payments shall be made on or before July 13, 2015, and are expressly conditioned upon approval on or before July 6, 2015, 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 2015 for the disproportionate share payments.

(b) For federal fiscal year 2016, commencing on October 1, 2015, and ending September 30, 2016, 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 DSH Plan to provide:

(1) That the disproportionate-share hospital payments to all participating hospitals, not to exceed an aggregate limit of $138.2 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 DSH Plan shall be made on or before July 11, 2016, and are expressly conditioned upon approval on or before July 5, 2016, 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 2016 for the DSH Plan.

(c) For federal fiscal year 2017, commencing on October 1, 2016, and ending September 30, 2017, 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 DSH Plan to provide:

(1) That the DSH Plan to all participating hospitals, not to exceed an aggregate limit of $139.7 million, shall be allocated by the executive office of health and human services to the Pool D component 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 11, 2017, and are expressly conditioned upon approval on or before July 5, 2017, 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 2017 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.

(e) The executive office of health and human services is directed, on at least a monthly basis, to collect patient-level uninsured information, including, but not limited to, demographics, services rendered, and reason for uninsured status from all hospitals licensed in Rhode Island.

(f) Beginning with federal FY 2016, Pool D DSH payments will be recalculated by the state based on actual hospital experience. The final Pool D payments will be based on the data from the final DSH audit for each federal fiscal year. Pool D DSH payments will be redistributed among the qualifying hospitals in direct proportion to the individual, qualifying hospital's uncompensated-care to the total uncompensated-care costs for all qualifying hospitals as determined by the DSH audit. No hospital will receive an allocation that would incur funds received in excess of audited uncompensated-care costs.

History of Section.
(P.L. 1996, ch. 100, art. 42, § 1; P.L. 1997, ch. 30, art. 21, § 1; P.L. 1998, ch. 31, art. 7, § 1; P.L. 1999, ch. 31, art. 15, § 1; P.L. 2000, ch. 55, art. 16, § 1; P.L. 2001, ch. 77, art. 25, § 1; P.L. 2002, ch. 65, art. 21, § 1; P.L. 2003, ch. 376, art. 19, § 1; P.L. 2004, ch. 595, art. 9, § 1; P.L. 2005, ch. 117, art. 9, § 1; P.L. 2006, ch. 246, art. 13, § 1; P.L. 2007, ch. 73, art. 19, § 1; P.L. 2008, ch. 100, art. 19, § 1; P.L. 2009, ch. 68, art. 19, § 1; P.L. 2010, ch. 23, art. 15, § 1; P.L. 2011, ch. 151, art. 18, § 1; P.L. 2012, ch. 241, art. 15, § 1; P.L. 2013, ch. 144, art. 12, § 1; P.L. 2014, ch. 145, art. 17, § 1; P.L. 2015, ch. 141, art. 5, § 14; P.L. 2016, ch. 142, art. 7, § 3.)