2012 New York Consolidated Laws
PBH - Public Health
Article 28 - (2800 - 2823) HOSPITALS
2807-W - High need indigent care adjustment pool.

 
    §  2807-w.  High  need  indigent care adjustment pool. Funds allocated
  pursuant to paragraph (p) of subdivision  one  of  section  twenty-eight
  hundred  seven-v  of  this article, shall be deposited as authorized and
  used for the purpose of making medicaid disproportionate share  payments
  of  up  to eighty-two million dollars on an annualized basis pursuant to
  subdivision twenty-one of section twenty-eight hundred seven-c  of  this
  article,  for  the  period  January  first,  two  thousand through March
  thirty-first, two thousand fourteen, in accordance with the following:
    1. From the funds in the pool  each  year:  (a)  Each  eligible  rural
  hospital  shall  receive  one  hundred  forty  thousand  dollars  on  an
  annualized basis for the periods January  first,  two  thousand  through
  December   thirty-first,   two   thousand   fourteen,   provided   as  a
  disproportionate share payment; provided, however, that if such  payment
  pursuant   to   this   paragraph   exceeds   a   hospital's   applicable
  disproportionate share limit, then the total amount in  excess  of  such
  limit  shall  be  provided as a nondisproportionate share payment in the
  form of a grant directly  from  this  pool  without  allocation  to  the
  special  revenue  funds  -  other,  indigent  care  fund  -  068, or any
  successor fund or  account,  and  provided  further  that  payments  for
  periods  on  and after January first, two thousand nine shall be subject
  to the provisions of subdivision five-a of section twenty-eight  hundred
  seven-k of this article;
    (b)  Each  such  hospital  shall  also receive an amount calculated by
  multiplying the facility's uncompensated care need  by  the  appropriate
  percentage from the following scale based on hospital rankings developed
  in  accordance  with each eligible rural hospital's weight as defined by
  this section.
 
                 Rank                      Percentage Coverage of
                                           Uncompensated Care Need
 
                  1-9                             60.0%
                 10-17                            52.5%
                 18-25                            45.0%
                 26-33                            37.5%
                 34-41                            30.0%
                 42-49                            22.5%
                 50-57                            15.0%
                   58+                             7.5%
 
    For purposes of calculating the distribution  amount  to  an  eligible
  rural  hospital  which  has  merged  with  another  hospital on or after
  December thirty-first, nineteen hundred ninety-nine, and continues to be
  an eligible rural hospital in accordance  with  paragraph  (c)  of  this
  subdivision,  such merged facility's uncompensated care need pursuant to
  this paragraph shall be calculated from data provided  in  the  eligible
  rural hospital's institutional cost report filed for the rate period two
  years  prior  to  the  distribution  period,  or  if  such report is not
  required for such rural hospital, the distribution amount shall be based
  upon the last institutional cost report required to  be  filed  by  such
  rural hospital.
    (c)  "Eligible  rural hospital", as used in this section, shall mean a
  general hospital that as  of  December  thirty-first,  nineteen  hundred
  ninety-nine  or  thereafter,  was  classified  as  a  rural hospital for
  purposes of determining  payment  for  inpatient  services  provided  to
  beneficiaries  of  title  XVIII  of  the  federal  social  security  act
  (medicare) or under state regulations,  or  a  general  hospital,  which
  during  the  same  time  period, had a service area which has an average

  population of less than one  hundred  seventy-five  persons  per  square
  mile,  or  a  general  hospital  which  has  a service area which has an
  average population of less than two  hundred  persons  per  square  mile
  measured  as  population  density by zip code. The average population of
  the service area is calculated by multiplying annual patient  discharges
  by the population density per square mile of the county of origin or zip
  code  as  applicable  for  each  patient discharge and dividing by total
  discharges.  Annual  patient  discharges  shall  be   determined   using
  discharge  data  for  the  nineteen  hundred  ninety-seven rate year, as
  reported  to  the  commissioner  by  October  first,  nineteen   hundred
  ninety-eight.  Population  density  shall be determined utilizing United
  States census bureau data  for  nineteen  hundred  ninety-seven.  If  an
  eligible  rural  hospital  merges  with  another general hospital, on or
  after December  thirty-first,  nineteen  hundred  ninety-nine,  and  the
  merger  results in separate facilities operating under a single facility
  operating certificate, such eligible rural hospital shall continue to be
  a separate eligible rural hospital for purposes of this subdivision  and
  payments  provided  in accordance with this section shall be made to the
  merged entity; provided, however, that payments shall only  be  made  to
  the  merged entity if such separate eligible rural hospital continues to
  provide inpatient  and/or  outpatient  hospital  services  at  the  same
  location  at which it operated prior to the merger. If an eligible rural
  hospital merges with another  general  hospital  on  or  after  December
  thirty-first,  nineteen  hundred  ninety-nine, and the merger results in
  such rural hospital continuing to  operate  under  a  separate  facility
  operating  certificate,  such  rural  hospital  will  continue  to be an
  eligible rural  hospital  after  the  merger;  provided,  however,  that
  payments  shall  only  be  made  to such rural hospital if such eligible
  rural hospital continues to provide inpatient and/or outpatient hospital
  services at the same location at which  it  is  operated  prior  to  the
  merger.
    (d)  "Eligible  rural hospital weight", as used in this section, shall
  mean the result of adding, for each eligible rural hospital:
    (i) The eligible rural hospital's targeted need, as defined in section
  twenty-eight hundred seven-k of this article, minus  the  mean  targeted
  need for all eligible rural hospitals, divided by the standard deviation
  of the targeted need of all eligible rural hospitals; and
    (ii) The mean number of beds of all eligible rural hospitals minus the
  number  of  beds  for  an  individual  hospital, divided by the standard
  deviation of the number of beds for all eligible rural hospitals.
    2. From the funds in the pool each year, thirty-six million dollars on
  an annualized basis for the periods January first, two thousand  through
  December   thirty-first,   two  thousand  fourteen,  of  the  funds  not
  distributed in accordance with subdivision one of this section, shall be
  distributed in accordance with the formula set forth in subdivision  six
  of  section  twenty-eight  hundred  seven-k  of  this article, provided,
  however, that payments for periods  on  and  after  January  first,  two
  thousand  nine  shall be subject to the provisions of subdivision five-a
  of section twenty-eight hundred seven-k of this article.
    3. From the funds in the pool each year, any funds not distributed  in
  accordance  with  subdivision  one  or  two  of  this  section, shall be
  distributed in accordance with the formula set forth in paragraph (b) of
  subdivision  four  of  section  twenty-eight  hundred  seven-k  of  this
  article.
    4.  In  order  for a general hospital to be eligible to participate in
  the distribution  of  funds  pursuant  to  this  section,  such  general
  hospital must be in compliance with the provisions of subdivisions nine,
  ten and twelve of section twenty-eight hundred seven-k of this article.

    5.  For  each hospital receiving payments pursuant to paragraph (i) of
  subdivision thirty-five of section twenty-eight hundred seven-c of  this
  article,  the  commissioner  shall  reduce  the  sum of any amounts paid
  pursuant to this section and pursuant to  section  twenty-eight  hundred
  seven-k  of  this  article,  as  computed  based  on  projected facility
  specific disproportionate share hospital ceilings, by an amount equal to
  the lower of such sum or  each  such  hospital's  payments  pursuant  to
  paragraph (i) of subdivision thirty-five of section twenty-eight hundred
  seven-c   of  this  article,  provided,  however,  that  any  additional
  aggregate reductions enacted in a chapter of the laws  of  two  thousand
  ten  to  the  aggregate  amounts  payable  pursuant  to this section and
  pursuant to section twenty-eight hundred seven-k of this  article  shall
  be  applied subsequent to the adjustments otherwise provided for in this
  subdivision.