# 89 Ill. Adm. Code 1480.148.200: Section 148.200 Critical Access Hospital OB and Other Treatment Services Payment (CAHOOTS)

> Illinois · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P1480_S148_200

## Section

- **Citation:** 89 Ill. Adm. Code 1480.148.200
- **Heading:** Section 148.200 Critical Access Hospital OB and Other Treatment Services Payment (CAHOOTS)
- **Jurisdiction:** Illinois
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Illinois Administrative Code / Title 89  /  / Part 1480  / Section 148.200 Critical Access Hospital OB and Other Treatment Services Payment (CAHOOTS)

## Text

Section 148
TITLE 89: SOCIAL SERVICES
CHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
SUBCHAPTER d: MEDICAL PROGRAMS
PART 148 HOSPITAL SERVICES
SECTION 148.200 CRITICAL ACCESS HOSPITAL OB AND OTHER TREATMENT SERVICES PAYMENT (CAHOOTS)
Section 148.200  Critical Access Hospital OB and Other
Treatment Services Payment (CAHOOTS)
a)         To
qualify for CAHOOTS payments, pursuant to 305 ILCS 5/5A-12.7(o) or 305 ILCS
5/14-12.7, a hospital must meet the following criteria:
1)         Be located
in Illinois; and
2)         Meet
the definition of a Critical Access Hospital as defined in Section 148.25(g).
b)         Each
hospital qualifying under subsection (a) that is owned or operated by an
Illinois government body or municipality, shall be paid a quarterly CAHOOTS
payment equal to the product of:
1)         $875,000;
and.
2)         The
lower of:
A)        A
quotient of:
i)          the
numerator of which is the hospital's adjusted outpatient claims in the data
quarter; and
ii)         the
denominator of which is the total of all qualifying hospitals' adjusted
outpatient claims in the data quarter; or
B)        10%.
c)         Each
hospital qualifying under subsection (a) that is not owned or operated by an
Illinois government body or municipality, shall be paid a quarterly CAHOOTS
payment equal to the product of:
1)         $2,500,000;
and.
2)         The
lower of:
A)        A
quotient of:
i)          the
numerator of which is the hospital's adjusted outpatient claims in the data
quarter; and
ii)         the
denominator of which is the total of all qualifying hospitals' adjusted
outpatient claims in the data quarter; or,
B)        10%.
d)         Any
funds that remain after the payments described in in subsections (b) and (c)
are complete will be distributed to qualifying hospitals in the payment quarter
that have not reached the 10% limitations
nt claims in the data
quarter; and
ii)         the
denominator of which is the total of all qualifying hospitals' adjusted
outpatient claims in the data quarter; or,
B)        10%.
d)         Any
funds that remain after the payments described in in subsections (b) and (c)
are complete will be distributed to qualifying hospitals in the payment quarter
that have not reached the 10% limitations. These payments will be equal to the
product of:
1)         All
remaining funds; and
2)
A quotient of:
A)        The
numerator of which is the hospital's total adjusted outpatient claims in the
data quarter; and
B)        The
denominator of which is the total of all qualifying hospitals' adjusted
outpatient claims in the data quarter for those hospitals that have not reached
the 10% limitation.
e)         Definitions
1)         "Adjusted
Outpatient Claims" means the number of paid MCO encounter outpatient
claims for services covered under Title XIX of the Social Security Act,
excluding days for individuals eligible for Medicare under Title XVIII of the
Social Security Act (Medicaid/Medicare crossover days), received by the
Department during the data quarter multiplied by 1.5 for qualifying hospitals
that are designated as a perinatal hospital with the Illinois Department of
Public Health during the payment quarter or multiplied by 1.0 for qualifying
hospitals that do not have that designation.
2)         "Data
Quarter" means the quarter of the calendar year that begins six months and
ends three months prior to the payment period.
3)         "Payment
Quarter" means the quarter of the calendar year that the payments will be
made.

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T89_P1480_S148_200. Check the current official text before relying on it. Not legal advice.