Introduced Version






HOUSE BILL No. 1772

_____


DIGEST OF INTRODUCED BILL



Citations Affected: IC 12-15-19.

Synopsis: Mental health disproportionate share funding. Amends disproportionate share payment provisions for community mental health center disproportionate share providers.

Effective: July 1, 2004 (retroactive).





Bauer




    January 19, 2005, read first time and referred to Committee on Public Health.







Introduced

First Regular Session 114th General Assembly (2005)


PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana Constitution) is being amended, the text of the existing provision will appear in this style type, additions will appear in this style type, and deletions will appear in this style type.
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HOUSE BILL No. 1772



    A BILL FOR AN ACT to amend the Indiana Code concerning human services.

Be it enacted by the General Assembly of the State of Indiana:

SOURCE: IC 12-15-19-9.5; (05)IN1772.1.1. -->     SECTION 1. IC 12-15-19-9.5 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2004 (RETROACTIVE)]: Sec. 9.5. (a) For each state fiscal year ending after June 30, 2004, a community mental health center disproportionate share provider that is:
        (1) freestanding from a hospital licensed under IC 16-21; and
        (2) not operated as part of a hospital licensed under IC 16-21;
shall receive a disproportionate share payment as provided in this section.
    (b) Subject to subsection (f), a community mental health center disproportionate share provider described in subsection (a) shall receive a payment in the amount determined under STEP THREE of the following formula:
        STEP ONE: Determine the amounts certified for the community mental health center disproportionate share provider under IC 12-15-18-5.1(e).
        STEP TWO: Divide the amount determined under STEP

ONE by a percentage equal to the state's federal medical assistance percentage for the state fiscal year.
        STEP THREE: Subtract the amount determined under STEP ONE from the amount determined under STEP TWO.
    (c) A disproportionate share payment under this section is considered of:
        (1) the amounts certified for the community mental health center disproportionate share provider under IC 12-15-18-5.1(e); and
        (2) the amount paid to the community mental health center disproportionate share provider under subsection (b).
    (d) A disproportionate share payment under this section may not exceed the community mental health center disproportionate share provider's institution specific limit under 42 U.S.C. 1396r-4(g). The office shall determine the institution specific limit for a state fiscal year by taking into account data provided by the community mental health center disproportionate share provider that is considered reliable by the office based on:
        (1) a periodic audit system;
        (2) the use of trending factors; and
        (3) an appropriate base year determined by the office.
    (e) The office may require independent certification of data provided by a community mental health center disproportionate share provider to the office in order to determine the community mental health center disproportionate share provider's institution specific limit.
    (f) Subject to section 10(b)(2) and 10(b)(3) of this chapter, payments under this section may not result in total disproportionate share payments that are in excess of the state limit on these expenditures for institutions for mental diseases under 42 U.S.C. 1396r-4(h). The office may reduce payments due under this section for a state fiscal year, on a pro rata basis, if the reduction is necessary to avoid exceeding the state limit on disproportionate share expenditures for institutions for mental diseases.
    (g) Subject to section 10(b)(3) of this chapter, total disproportionate share payments under this section for a state fiscal year must equal ten million dollars ($10,000,000). However, this amount may be reduced based upon the amounts certified for community mental health center disproportionate share providers under IC 12-15-18-5.1(e). The office may reduce the payments due under this section, on a pro rata basis, based upon the institution

specific limits under 42 U.S.C. 1396r-4(g) of each community mental health center disproportionate share provider eligible for a payment under this section for that state fiscal year, if the reduction is necessary to avoid exceeding the total payment limit established under this subsection.
    (h) The office may recover a payment made under subsection (b) from the community mental health center disproportionate share provider if federal financial participation is disallowed for the funds certified under IC 12-15-18-5.1(e) upon which the payment was based.

SOURCE: IC 12-15-19-10; (05)IN1772.1.2. -->     SECTION 2. IC 12-15-19-10 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2004 (RETROACTIVE)]: Sec. 10. (a) For the state fiscal year beginning July 1, 1999, and ending June 30, 2000, the state shall pay providers as follows:
        (1) The state shall make disproportionate share provider payments to municipal disproportionate share providers qualifying under IC 12-15-16-1(b) until the state exceeds the state disproportionate share allocation (as defined in 42 U.S.C. 1396r-4(f)(2)).
        (2) After the state makes all payments under subdivision (1), if the state fails to exceed the state disproportionate share allocation (as defined in 42 U.S.C. 1396r-4(f)(2)), or the state limit on disproportionate share expenditures for institutions for mental diseases (as defined in 42 U.S.C. 1396r-4(h)), the state shall make community mental health center disproportionate share provider payments to providers qualifying under IC 12-15-16-1(c). The total paid to the qualified community mental health center disproportionate share providers under section 9(a) of this chapter, including the amount of expenditures certified as being eligible for federal financial participation under IC 12-15-18-5.1(e), must be at least six million dollars ($6,000,000).
        (3) After the state makes all payments under subdivision (2), if the state fails to exceed the state disproportionate share allocation (as defined in 42 U.S.C. 1396r-4(f)(2)), the state shall make disproportionate share provider payments to providers qualifying under IC 12-15-16-1(a).
    (b) For state fiscal years beginning after June 30, 2000, the state shall pay providers as follows:
        (1) The state shall make municipal disproportionate share provider payments to providers qualifying under IC 12-15-16-1(b) until the state exceeds the state disproportionate share allocation (as defined in 42 U.S.C. 1396r-4(f)(2)).
        (2) After the state makes all payments under subdivision (1), if the state fails to exceed the state disproportionate share allocation (as defined in 42 U.S.C. 1396r-4(f)(2)), the state shall make disproportionate share provider payments to providers qualifying under IC 12-15-16-1(a). Beginning in a state fiscal year ending after June 30, 2004, the total disproportionate share payments made to a state mental health institution described in IC 12-24-1-3 must be limited to an amount necessary to permit disproportionate share payments to be made under section 9.5 of this chapter without exceeding the state limit on disproportionate share expenditures for institutions for mental diseases under 42 U.S.C. 1396r-4(h).
        (3) After the state makes all payments under subdivision (2), if the state fails to exceed the state disproportionate share allocation (as defined in 42 U.S.C. 1396r-4(f)(2)), or the state limit on disproportionate share expenditures for institutions for mental diseases (as defined in 42 U.S.C. 1396r-4(h)), the state shall make community mental health center disproportionate share provider payments to providers qualifying under IC 12-15-16-1(c). disproportionate share payments under section 9.5 of this chapter.
SOURCE: ; (05)IN1772.1.3. -->     SECTION 3. An emergency is declared for this act.