DISPROPORTIONATE SHARE HOSPITAL POLICY

Regulation Authority:

RIGL 48-8.3-3; Title XIX of the Social Security Act

Purpose and Reason:

The Department of Human Services (DHS) will submit to the federal Centers for Medicare & Medicaid Services (CMS) an amendment to the State of Rhode Island’s Medicaid State Plan (SPA) relative to disproportionate share hospital payments to be made on or after July 1, 2004 to: 1) change the base year for determining qualifying uncompensated care costs for non-government and state operated hospitals from hospital fiscal year 2001 to hospital fiscal year 2003, and to correspondingly adjust aggregate payment levels for Pools A, B, C, and D; 2) provide for “Pool D” payment adjustments to non-government hospitals to be distributed among the qualifying hospitals in direct proportion to the individual qualifying hospital’s uncompensated care (as defined in the SPA) to the total uncompensated care costs for all qualifying hospitals; 3) limit “Pool H” payment adjustments to an amount not to exceed to $1 million; and 4) make textual revisions in the SPA consistent with the foregoing proposed changes.

Brief statement of Reason for Finding Imminent Peril:

NO_DIGITAL_DATA