Sec. 15-5. Disbursements from the Fund.

530 words·~2 min read·/il/chapter-305/act-5/15-5

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

(a)The monies in the Fund shall be disbursed only as provided in Section 15-2 of this Code and as follows:

(1)To the extent that such costs are reimbursable under federal law, to pay the county

hospitals' inpatient reimbursement rates based on actual costs incurred, trended forward annually by an inflation index.

(2)To the extent that such costs are reimbursable under federal law, to pay county

hospitals and county operated outpatient facilities for outpatient services based on a federally approved methodology to cover the maximum allowable costs.

(3)To pay the county hospitals disproportionate share hospital adjustment payments as

may be specified in the Illinois Title XIX State plan.

(3.5) To pay county providers for services provided or purchased pursuant to Section

5-11 of this Code.

(4)To reimburse the county providers for expenses contractually assumed pursuant to

Section 15-4 of this Code.

(5)To pay the Illinois Department its necessary administrative expenses relative to the

Fund and other amounts agreed to, if any, by the county providers in the agreement provided for in subsection (c).

(6)To pay the county providers any other amount due according to a federally approved

State plan, including but not limited to payments made under the provisions of Section 701(d)(3)(B) of the federal Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000. Intergovernmental transfers supporting payments under this paragraph

(6)shall not be subject to the computation described in subsection

(a)of Section 15-3 of this Code, but shall be computed as the difference between the total of such payments made by the Illinois Department to county providers less any amount of federal financial participation due the Illinois Department under Titles XIX and XXI of the Social Security Act as a result of such payments to county providers.

(b)The Illinois Department shall promptly seek all appropriate amendments to the Illinois Title XIX State Plan to maximize reimbursement, including disproportionate share hospital adjustment payments, to the county providers.

(c)(Blank).

(d)The payments provided for herein are intended to cover services rendered on and after July 1, 1991, and any agreement executed between a qualifying county and the Illinois Department pursuant to this Section may relate back to that date, provided the Illinois Department obtains federal approval. Any changes in payment rates resulting from the provisions of Article 3 of this amendatory Act of 1992 are intended to apply to services rendered on or after October 1, 1992, and any agreement executed between a qualifying county and the Illinois Department pursuant to this Section may be effective as of that date.

(e)If one or more hospitals file suit in any court challenging any part of this Article XV, payments to hospitals from the Fund under this Article XV shall be made only to the extent that sufficient monies are available in the Fund and only to the extent that any monies in the Fund are not prohibited from disbursement and may be disbursed under any order of the court.

(f)All payments under this Section are contingent upon federal approval of changes to the Title XIX State plan, if that approval is required.