Section 148.116 Reimbursement Methodologies for Children's Specialty Hospitals

TITLE 89: SOCIAL SERVICES

CHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

SUBCHAPTER d: MEDICAL PROGRAMS

PART 148 HOSPITAL SERVICES

SECTION 148.116 REIMBURSEMENT METHODOLOGIES FOR CHILDREN'S SPECIALTY HOSPITALS

Section 148.116

Reimbursement Methodologies for Children's Specialty Hospitals

Effective for dates of outpatient

services on or after July 1, 2014 and inpatient discharges on or after July 1,

2014:

a)         Inpatient general acute care services

provided by a children's specialty hospital located in Illinois, as defined in

Section 148.25(i) and excluded from the DRG PPS pursuant to 89 Ill. Adm. Code

149.50(b), shall, per day of covered inpatient care, be reimbursed as follows:

1)         For a hospital that would not have met the

definition of a children's specialty hospital as of July 1, 2013, $1,400.00 per

day.

2)         For a hospital or a cost reporting hospital

located outside of Illinois that would have met the definition of a children's

specialty hospital as of July 30, 2023, a rate equal to $2,003.13.

3)         The total payment for inpatient stay will

equal the sum of:

A)        The payment determined in this subsection;

and

B)        Any applicable adjustments to payment

specified in Section 148.290.