Agencies
Services
Provider Notice issued 08/18/09
Cost Outlier Payment Calculation – Change to Children´s Hospital Eligibility
| To: |
Participating Hospitals: Chief Executive Officers, Chief Financial Officers, and Patient Accounts Managers |
| Date: | August 18, 2009 |
| Re: |
Cost Outlier Payment Calculation – Change to Children´s Hospital Eligibility |
The purpose of this bulletin is to advise hospitals of new policy regarding outlier payments to children’s hospitals, effective with admission dates beginning July 1, 2009.
As a result of a recent emergency amendment to 89 Illinois Administrative Code Section 148.130, children’s hospitals, as defined in 89 Illinois Administrative Code Section 149.50 (c)(3)(B), are now eligible to receive outliers on claims for children through the age of 18.
The department is currently in the process of completing the necessary programming changes. After the new programming is implemented, the department will determine what claim adjustments are necessary and will adjust any affected paid claims.
This bulletin and the replacement handbook page may be obtained from the department’s Web site at: <http://www.hfs.illinois.gov/hospitals/>. The revisions in the replacement pages are identified by an “=” to the left of the affected text. Paper copies of the revised pages may be obtained by written request. To ensure delivery, you must specify a physical street address when requesting a paper copy.
You may submit your written request to the address below, or fax or e-mail it as noted:
Healthcare and Family Services
Provider Participation Unit
Post Office Box 19114
Springfield, Illinois 62794-9114
Fax Number: (217) 557-8800 / E-Mail Address: hfs.ppu@illinois.gov
Outlier Adjustment Calculation for Per Diem Priced Claims (pdf)