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Elizabeth M. Whitehorn, Director

Provider Notice Issued 07/14/2017

​Updates to Critical Access Hospital EAPG Standardized Amount

​TO:

​Enrolled Hospitals: Chief Executive Officers, Chief Financial Officers, and Patient Accounts Managers
​Date: ​July 14, 2017
​RE: ​​Updates to Critical Access Hospital EAPG Standardized Amount

In accordance with 89 IL Admin Code 148.140(d)(3), the Department of Healthcare and Family Services (HFS) is updating the EAPG standardized amounts for Critical Access Hospitals.  Effective with dates of service on or after July 1, 2017:

  • Critical Access Hospital EAPG Standardized Amount.  For critical access hospitals, as defined in Section 148.25(g), the EAPG standardized amounts are determined separately for each critical access hospital such that simulated EAPG payments using outpatient base period paid claim data plus payments as defined in Section 148.456 net of tax costs are equal to the estimated costs of outpatient base period claims data with a rate year cost inflation factor applied 

For those hospitals affected, new rate sheets are posted to the Department’s website: Hospital Rate Sheets Effective July 1, 2017.  Hospitals can access their rate sheet by clicking on the appropriate link.   An updated version of the Outpatient EAPG pricing calculator including these rates has also been posted.  

 

Per 89 IL Admin Code 148.310(f), hospitals can appeal the accuracy of the updated EAPG standardized amounts through a written request for review that must be submitted in writing and must either be received by the Department, or post marked within 30 days after the date of this notice.  Therefore, the deadline for appeals is August 14, 2017.  Please direct all appeals and supporting documentation to:

Illinois Department of Healthcare and Family Services

Bureau of Rate Development and Analysis

Attn: Laura Roberts

201 South Grand Avenue East, 2nd Floor

Springfield, Illinois 62763

For questions regarding this notice, please contact the Bureau of Rate Development and Analysis at (217) 785-0710.

 

Sincerely,

 

Dan Jenkins, Chief

Bureau of Rate Development and Analysis