Indiana Administrative Code
Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES
Article 1 - MEDICAID PROVIDERS AND SERVICES
Rule 13 - Disproportionate Share Hospital Payments
Section 13-1 - Eligibility
Universal Citation: 405 IN Admin Code 13-1
Current through March 20, 2024
Authority: IC 12-15-21-1; IC 12-15-21-3
Affected: IC 12-15-6
Sec. 1.
(a) Eligibility for basic and enhanced disproportionate share hospital payments for hospital providers that are not owned or operated by the state will be determined using a provider's Medicaid inpatient utilization rate and low income utilization rate based on utilization and revenue data from the cost reporting period used to determine that provider's eligibility for disproportionate share payments as of July 1, 1992.
(b) Hospital providers that are owned or operated by the state are eligible for disproportionate share hospital payments for a fiscal year if:
(1) for any portion of
that fiscal year, the provider meets CMS's conditions of participation for the
Medicare program;
(2) for any
portion of that fiscal year, the provider is eligible for Medicaid
payments;
(3) the hospital's low
income utilization rate for that fiscal year exceeds twenty-five percent (25%);
and
(4) the hospital's Medicaid
utilization rate exceeds one percent (1%).
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