ARTICLE 9 SUBSTITUTE A
RELATING TO HOSPITAL UNCOMPENSATED CARE
SECTION 1. Sections 40-8.3-2 and 40-8.3-3 of the General Laws in Chapter
40-8.3 entitled “Uncompensated Care” are hereby amended to read as follows:
40-8.3-2. Definitions. – As used in this chapter:
(1) "Base year" means for the purpose
of calculating a disproportionate share payment for any fiscal year ending
after September 30, 2004 2005, the period from October 1, 2002 2003 through September 30, 2003 2004.
(2) "Medical assistance inpatient utilization rate for a hospital" means a fraction (expressed as a percentage) the numerator of which is the hospital's number of inpatient days during the base year attributable to patients who were eligible for medical assistance during the base year and the denominator of which is the total number of the hospital's inpatient days in the base year.
(3) "Participating hospital" means any nongovernment and nonpsychiatric hospital that: (i) was licensed as a hospital in accordance with chapter 17 of title 23 during the base year, (ii) achieved a medical assistance inpatient utilization rate of at least one percent (1%) during the base year, and (iii) continues to be licensed as a hospital in accordance with chapter 17 of title 23 during the payment year.
(4) "Uncompensated care costs" means, as to any hospital, the sum of: (i) the cost incurred by such hospital during the base year for inpatient or outpatient services attributable to charity care (free care and bad debts) for which the patient has no health insurance or other third-party coverage less payments, if any, received directly from such patients and (ii) the cost incurred by such hospital during the base year for inpatient or out-patient services attributable to medicaid beneficiaries less any medicaid reimbursement received therefor; multiplied by the uncompensated care index.
(5) "Uncompensated care index" means
the annual percentage increase for hospitals established pursuant to § 27-19-14
for each year after the base year, up to and including the payment year,
provided, however, that the uncompensated care index for the payment year ending September 30, 2004 shall be deemed to be five and
twenty-five hundredths percent (5.25%), and that the uncompensated care index
for the payment year ending September 30, 2005 shall be deemed to be
five and twenty-five hundredths percent (5.25%)
five and eighty-five hundredths percent (5.85%),
and that the uncompensated care index for the payment year ending September 30,
2006 shall be deemed to be five and fifty hundredths percent (5.50%).
40-8.3-3. Implementation. – (a) For the fiscal year commencing on October 1, 2004 2005
and ending September 30, 2005 2006, the department of 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) disproportionate share hospital payments to all participating
hospitals not to exceed an aggregate limit of $82.3
$97.8 million, to be allocated by the
department to the Pool A, Pool C and Pool D components of the DSH Plan;
(2) that the Pool D allotment shall be distributed among the
participating hospitals in direct proportion to the individual participating
hospitals 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 December 14, 2004 15, 2005 and are expressly conditioned upon
approval on or before December 8, 2004 2005 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 2005 2006
for the disproportionate share payments.
(b) 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.
SECTION 2. This article shall take
effect upon passage.