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Hospital Care Assurance Program Update Ohio Hospital Association Annual Meeting June 14, 2011

. Hospital AssessmentsFederal Funds Total $198.7 M $346.4 M $545.1 M2011 program $23 million smaller than 2010 program;Loss of ARRA stimulus support Assessment (preliminary) 0.8638643% on costs up to $216,372,500 and 0.588007% on costs above; Distribution policy unchanged from 2010Proportional reductions to all funding potsHospital closure redistributionJFS expected to file rules soon/begin state process.

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Hospital Care Assurance Program Update Ohio Hospital Association Annual Meeting June 14, 2011

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    1. Hospital Care Assurance Program Update Ohio Hospital Association Annual Meeting June 14, 2011 Ryan Biles Vice President Fiscal Policy Ohio Hospital Association ryanb@ohanet.org Charles Cataline Senior Director, Health Policy Fiscal Policy Ohio Hospital Association charlesc@ohanet.org 1 OHA Annual Meeting June 14, 2011

    2. June 14, 2011 2 OHA Annual Meeting

    3. Statewide totals: (in millions) HCAP 2010 HCAP 2011 % Change (SFY 2009 Cost Reports) (SFY 2010 Cost Reports) Uninsured Uncomp.: Patient Income = FPL $533.1 $600.6 12.7% Patient Income > FPL $561.4 $600.4 6.9% FFS Medicaid Losses $181.1 $146.3 (19.0%) Managed Medicaid Losses $473.8 $499.3 5.5% OBRA Cap (DSH Limit) $1,749.4 $1,846.8 5.6% High DSH Utilization Threshold: 23.59% 24.46% 3.7% # of Hospitals in Program: 199 204 2.5% HCAP 2011 Preliminary Data Inputs June 14, 2011 3 OHA Annual Meeting

    4. 4 June 14, 2011 OHA Annual Meeting

    5. 5 June 14, 2011 OHA Annual Meeting

    6. State process running behind due to budget Rules expected to be filed soon No CMS approval process necessary Payments likely in October HCAP 2011 Timeline June 14, 2011 6 OHA Annual Meeting

    7. Questions/Concerns/Comments? HCAP June 14, 2011 7 OHA Annual Meeting

    8. SFY 2011 Medicaid Cost Reporting and DSH Audit Requirements 8 OHA Annual Meeting June 14, 2011

    9. SFY 2011 Medicaid Cost Report Three New Sub-Schedules F F1 – Disability Assistance Detail F2 – Uncompensated Care <100% FPL Detail F3 – Uncompensated Care >100% FPL Detail IP & OP, Charge & Cost Data Broken Down Into Insured & Uninsured Lines for 56 Cost Center Categories CR Cost Centers = Bundled UB-04 Revenue Codes 9 OHA Annual Meeting June 14, 2011

    10. SFY 2011 Medicaid Cost Report Three New Sub-Schedules F Created to Support Federal DSH Audits CMS Protocols Include Examination of Allowed Cost by CR Cost Center OHA Requesting Assistance from CMS SFY 2011 Sub-schedules F Not Required Until 2012 CR Filed – If Not Before Should Not Require Auditor Re-Review at Filing SFY 2011 Due Date Extended One Month for 7/1/10 Through 12/31/10 FYE Hospitals 10 OHA Annual Meeting June 14, 2011

    11. SFY 2008 Medicaid DSH Audits SFY 2008 DSH Audit Underway by Myers & Stauffer (See 2010 Materials for Background) Schedule F, Supporting Logs, Data Reviews and Action Plans Due at End of Month Expanded, Hospital-Specific Audits Expected Later This Summer No Indication Yet of How Many Hospitals Included SFY 2009 & 2010 to Follow This Year (?); Same Process (?) SFY 2008 – 2010 Still Considered Learning Curve; SFY 2011 Could Involve HCAP Re-Distribution 11 OHA Annual Meeting June 14, 2011

    12. Hospital HCAP-Related Free Care Requirement Updated Background Material in Handout Revised Frequently Asked-Questions Effective July, 1 2011 OHA Finance Committee Considering Extending Eligibility Effective Dates & Standardizing Required Procedures – Prospectively Effective Would Require Re-filing OAC 5101:3-2-07.17 Comments !? Stay Tuned 12 OHA Annual Meeting June 14, 2011

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