Section 405 IAC 1-13-1 - EligibilityAuthority: 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%).Office ofthe Secretary of Family and Social Services; 405 IAC 1-13-1; filed Jan 27, 1994, 5:00 p.m.: 17 IR 1090; filed May 25, 1995, 3:00 p.m.: 18 IR 2409; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; readopted filed Sep 19, 2007, 12:16 p.m.: 20071010-IR-405070311RFA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFAFiled 8/1/2016, 3:44 p.m.: 20160831-IR-405150418FRAReadopted filed 7/28/2022, 2:21 p.m.: 20220824-IR-405220205RFAReadopted filed 5/30/2023, 11:54 a.m.: 20230628-IR-405230292RFA