2023 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.