89 Ill. Adm. Code 148.300
Payment
Section 148
Section 148.300 Payment
Effective for dates of service
on or after July 1, 2014:
a) The Department will adjust rate methodologies used to
reimburse hospitals to assure compliance with applicable aggregate and
hospital-specific federal payment limitations.
b) Effect
of Change of Ownership on Payments. When a hospital's ownership changes,
payment for hospital services for each patient, including payment adjustments,
will be made to the entity that is the legal owner on the date of discharge. Payment
will not be prorated between the buyer and seller.
1) The
owner on the date of discharge is entitled to submit a bill for all inpatient
hospital services furnished regardless of when the client's coverage began or
ended during a stay, or how long the stay lasted.
2) Each
bill submitted must include all information necessary for the Department to
compute the payment amount, whether some of the information is attributable to
a period during which a different party legally owned the hospital.
c) Notwithstanding
any other provisions of 89 Ill. Adm. Code 148, 149 or 152, a hospital that is
located in a county of the State in which the Department mandates some or all
of the beneficiaries of the Medical Assistance Program residing in the county
to enroll in a Care Coordination Program, as defined in Section 5-30 of the
Illinois Public Aid Code, shall not be eligible for any non-claims based
payments not mandated by Article V-A of the Illinois Public Aid Code that it
would otherwise be qualified to receive, unless the hospital is a Coordinated
Care Participating Hospital, as defined in Section 148.25(f), no later than
August 14, 2012, or 60 days after the first mandatory enrollment of a
beneficiary in a Coordinated Care Program.