Section 148.115 Reimbursement Methodologies for Long Term Acute Care Services

TITLE 89: SOCIAL SERVICES

CHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

SUBCHAPTER d: MEDICAL PROGRAMS

PART 148 HOSPITAL SERVICES

SECTION 148.115 REIMBURSEMENT METHODOLOGIES FOR LONG TERM ACUTE CARE SERVICES

Section 148.115  Reimbursement

Methodologies for Long Term Acute Care Services

Effective with discharges on

or after July 1, 2014:

a)         Inpatient long term acute care psychiatric

services excluded from the DRG PPS pursuant to 89 Ill. Adm. Code 149.50(b)

shall be reimbursed under the inpatient psychiatric services methodologies

specified in Section 148.110.

b)         Inpatient long term acute care services

excluded from the DRG PPS shall be reimbursed a hospital-specific rate paid per

day of covered inpatient care, determined pursuant to this Section.  The total

payment for an inpatient stay will equal the sum of:

1)         the payment determined in this Section; and

2)         any applicable adjustments to payment

specified in Section 148.290.

c)         Payment for long term acute care services

provided by a long term acute care hospital, as defined in Section

148.25(d)(4):

1)         That was not enrolled with the Department on

December 31, 2023, shall be the product of the following:

A)        $800.16;

and

B)        The length of stay, as defined in 89 Ill.

Adm. Code 149.100(i).

2)         That was enrolled with the Department on

December 31, 2023, shall be the product of the following:

A)        The rate in effect on December 31, 2023

multiplied by 1.1; and

B)        The length of stay, as defined in 89 Ill.

Adm. Code 149.100(i).