Ill. Admin. Code tit. 89 § 152.100

Current through Register Vol. 48, No. 52, December 27, 2024

Section 152.100 - Hospital Rate Reductions

Notwithstanding any provision to the contrary in 89 Ill. Adm. Code 148 and 149 and this Part 152, effective for dates of service on or after July 1, 2012, any rate of reimbursement for services to hospitals or other payments to hospitals shall be reduced by an additional 3.5 % from the rates that were otherwise in effect on July 1, 2012 to July 1, 2021, except that those reductions shall not apply to:

a) Rates or payments for hospital services delivered by a Safety Net Hospital under Section 5-5e.1 of the Illinois Public Aid Code [305 ILCS 5 ].

b) Rates or payments for hospital services delivered by a Critical Access Hospital as defined in 89 Ill. Adm. Code 148.25(g).

c) Rates or payments for hospital services delivered by a hospital that is operated by a unit of local government or State university that provides some or all of the non-federal share of the services.

d) Payments authorized under Section 5A-12.4 of the Illinois Public Aid Code.

e) Transitional payment authorized in 89 Ill. Adm. Code 148.296.

f) Notwithstanding any other provision to the contrary in this Part, federally approved rates or payments for services related to a public health emergency that:

1) Appear on the Department's public health emergency published fee schedule; and

2) Meet the date of service specifications on the Department's public health emergency published fee schedule.

3) The Department's public health emergency published fee schedule shall remain in place until the Department determines the rates or payments described under this subsection (f) are no longer necessary to address a public health emergency, for reasons including, but not limited to: the establishment, termination, or modification of any applicable federal or State disaster declaration, Executive Orders of the Governor, or disaster-related flexibilities granted by federal agencies.

Ill. Admin. Code tit. 89, § 152.100

Added at 37 Ill. Reg. 10517, effective June 27, 2013

Amended at 38 Ill. Reg. 15527, effective 7/2/2014

Amended at 45 Ill. Reg. 8335, effective 6/28/2021

Amended at 47 Ill. Reg. 2714, effective 2/14/2023