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Elizabeth M. Whitehorn, Director

Provider Notice issued 06/25/12

Fiscal Year 2013 Hospital Inpatient Assessment Program Notice of Assessment

To:​ ​Illinois Hospital Providers
​Date: ​June 25, 2012
​Re: Fiscal Year 2013 Hospital Inpatient Assessment Program Notice of Assessment​

This is to inform you that the department has determined that your facility is subject to the inpatient assessment imposed on Illinois hospital inpatient services under the provisions of 305 ILCS 5/5-A.

Enclosed are your facility’s inpatient assessment remittance notices for fiscal year 2013. The top section of each notice contains the calculation of the inpatient assessment on an annual and monthly basis. The bottom section of the notice has the facility’s name and address, the tax identification number and personal identification number (PIN) assigned by the department, the total amount due, and the due date.

Hospitals must remit the monthly inpatient assessment using the Illinois State Treasurer’s E-Pay Program. In order to use this service, your hospital will need an Internet connection, checking account information (bank routing number and account number), from which the payment will be made, and the hospital’s current remittance card. If your hospital is not familiar with the Illinois State Treasurer’s E-Pay Program, please contact the Bureau of Program and Reimbursement Analysis at 217-524-7110.

In addition, each hospital is responsible for ensuring debit authorizations can be initiated from designated accounts in the appropriate dollar amount. Following is the company identification number to be given to your banking institution, if debit block filters are used on the hospital’s account. Please use 1550895818 for these transactions.

The methodology used to calculate the inpatient assessment amount, and copies of the statute (305 ILCS 5/V-A), and the administrative rules (89 Ill. Adm. Code 140.80) pertaining to the hospital assessment program may be found under “Laws and Rules” on the department’s Web site, Major Laws and Regulations Affecting HFS Operations page.

If you have any questions concerning this information, please do not hesitate to contact the Bureau of Program and Reimbursement Analysis, by e-mailing BPRA or by telephone at 217-524-7110.

Greg Wilson, Chief

Bureau of Program and Reimbursement Analysis