NY Pub Health L § 2807-W (2021)
2021 New York Laws PBH - Public Health Article 28 - 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.