January 19, 2012

HFS Hospital Cost Calculation Now Available by Request

As part of its Medicaid Hospital Reimbursement Reform, the Illinois Dept. of Healthcare and Family Services (HFS) last year gave hospitals the opportunity to review the mapping of revenue codes to your hospital's specific cost centers and provide changes by August 15, 2011. HFS' contractor made the requested changes to your mapping of revenue codes to your hospital's specific cost centers and will provide updated cost information with a detailed narrative of the cost analysis.

In order to obtain the updated cost information, hospitals must request the information by your hospital's name and Medicare ID from HFS by email at HFS.Hospitals@Illinois.gov. If you do not receive your information within 72 hours please contact HFS staff, Dan Jenkins at 217- 785-0710. We strongly recommend that you review the revised information especially if you provided HFS with changes for mapping of your revenue codes. The cost information is a very important aspect of Medicaid Hospital Reimbursement Reform as the department is planning to use the cost information to determine if inpatient funding should be reallocated to outpatient funding. In addition, HFS has proposed that it may shift funding under the new system between acute, psychiatric and rehabilitation to achieve consistent aggregate payment to cost ratios for each service type. This is your opportunity to validate your hospital's cost information as the HFS is calculating your cost.

HFS has indicated that hospitals will need to specifically authorize release of provider specific information to IHA staff for analysis. We are requesting that as part of your request, you direct the Department to share the file with IHA. Please direct the Department to send the information to Jo Ann Spoor at jspoor@ihastaff.org

For any other questions or comments, please contact Joe Holler at 217-541-1189 or Jo Ann Spoor at 217-541-1187.