89 Ill. Adm. Code 150.10
Definitions
Section 150.10 Definitions
For the purposes of this Part, the following definitions
apply:
"Acute care hospital"
means a hospital that has been assigned a CCN with the last four digits in the
series 0001-0879 or 1300-1399 and has an average length of a patient stay of 25
or fewer days. Multiple hospitals operating under a single CCN are, for
purposes of this Part, considered as a single hospital.
"Children's hospital"
means a hospital that predominately treats individuals under the age of 21 and
has been assigned a CMS certification number with the last four digits in the
series 3300-3399 or, in the instance of a hospital that does not participate in
Medicare, is licensed as a pediatric hospital by the Illinois Department of
Public Health.
"Coordinated care
participating hospital" means a hospital that is located in a geographic
area of the State in which HFS mandates some or all of the beneficiaries of the
Medical Assistance Program residing in the area to enroll in a care
coordination program, as defined in 305 ILCS 5/5-30, that has entered into a
contract to provide hospital services to enrollees of the care coordination
program; has not been offered a contract by a care coordination plan that pays
no less than HFS would have paid on a fee-for-service (FFS) basis, but
excluding disproportionate share hospital adjustment payments or any other
supplemental payment that HFS pays directly; or is not licensed to serve the
population mandated to enroll in the care coordination program.
"CCN" means CMMS
certification number, a six character identification number assigned to CMMS
Medicare and Medicaid providers (formerly known as the Medicare/Medicaid
provider number, the online survey, certification and reporting (OSCAR) number,
or the Medicare identification number).
"CMMS" means the Centers
for Medicare and Medicaid Services, the organizational unit within the U.S. Department
of Health and Human Services responsible for overseeing the Medicaid program.
"Department" means the
Department of Healthcare and Family Services.
"Hospital" means any
institution, place, building or agency, public or private, whether organized for
profit or not-for-profit, that is:
located in Illinois and is subject
to licensure by the Illinois Department of Public Health under the Hospital
Licensing Act [210 ILCS 85] or the University of Illinois Hospital Act [110
ILCS 330]; or
located in another state and meets
all comparable conditions and requirements of the Hospital Licensing Act in
effect for the state in which it is located.
"Medicaid" means medical
assistance provided pursuant to Title XIX of the federal Social Security Act,
as implemented pursuant to Article V of the Illinois Public Aid Code or a
comparable law in another state.
"Medicaid Managed Care Entity
(MMCE) participating hospitals" means a hospital that is located in a
geographic area of the State in which HFS offers enrollment with an MMCE as a
voluntary option to beneficiaries of the Medical Assistance Program and that
has entered into a contract to provide hospital services to enrollees of an
MMCE.
"Medicare" means health
insurance provided pursuant to Title XVIII of the federal Social Security Act.