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April 11, 2008
Rate Year 2009 Determinations for Medicaid DHS, MPA, CHAP and CTCA Payments
Please be aware that the Illinois Department of Healthcare and Family
Services (IDHFS) sent out an Action Notice, Thursday April 10, 2008 that
specifies the data that hospitals must submit for determination of eligibility
for rate year 2009 Medicaid Disproportionate Share (DSH), Medicaid Percentage
Adjustment (MPA), Critical Hospital Adjustment (CHAP), and County Trauma Center
Adjustment (CTCA) payments.
This memo is to advise you of the information required for the 2009 Medicaid
DSH, MPA, CHAP, and CTCA payments. To date, IDHFS has not issued the action
notice with the required reporting forms.
The majority of the deadlines for providing data to IDHFS for these payment
determinations are July 1, 2008, with a few exceptions as outlined below.
The data must be received by or postmarked (meter dates are not acceptable) by
these deadlines; information not received by this date will not be used in the
calculation.
Hospital Data Required
- Claims data
- Claims data for your hospital’s fiscal year 2006 and state fiscal year
2007 (July 1, 2006 – June 30, 2007) is utilized in determining these
adjustment payments. Claims that have not been adjudicated by June 30, 2008
will not be included in determinations.
- Submit any outstanding claims to ensure inclusion in the rate year 2009
determinations. With the current delays in the payment cycle, IHA recommends
that all outstanding claims be submitted immediately in order to be
adjudicated by June 30, 2008.
- Disproportionate Share Obstetrical Statement - Rate Year 2009
- Deadline is July 1, 2008
- The form certifies that the hospital is providing non-emergency
obstetrical services, which is a federal requirement for DSH payment
adjustments eligibility.
- Low Income Utilization Collection Form
- Deadline is July 1, 2008
- The form certifies that the hospital’s low income utilization rate (LIUR)
exceeds the required 25%. Form submission is not required if LIUR does not
exceed 25%.
- An audited certified financial statement and, if any, all other
supporting work papers, must be attached.
- Hospital’s 2006 Cost Report
- Deadline is July 1, 2008
- No action is required if the hospital’s 2006 Cost Report is audited.
- If the hospital’s 2006 Cost Report is unaudited, review for any
inaccuracies and, if applicable, submit a corrected or amended Cost Report
before the deadline stated.
- Statements for Out-of-State Medicaid Days
- Deadline is July 1, 2008
- Provide documentation from each State for out-of-state Medicaid days
that you want to be included, and submit to the department before the
deadline stated.
- OBRA’93 Data Collection Form New Requirement for all Hospitals
- Deadline is August 15, 2008
- Required for all hospitals.
- Hospital fiscal year 2006 uninsured information.
- Used by the Department to determine if it has met the federal guidelines
set forth in the Omnibus Budget Reconciliation Act of 1993.
Please be advised that IDHFS has been successful in gaining denial for
appeals related to these data submission requirements, so it is imperative that
hospitals meet the requirements set forth in the administrative rules. You can
download the Action Notice and all required forms by going to this web
site:
http://www.hfs.illinois.gov/hospitals.
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