Fee-for-Service ACA Hospital Access Payments and ACA Assessment Reconciliation Adjustment

July 2, 2018


Fee-for-Service ACA Hospital Access Payments and ACA Assessment Reconciliation Adjustment

In conjunction with the approval of the redesigned Hospital Assessment Program on June 20, 2018, the Department of Healthcare and Family Services (HFS) has informed IHA that the state has also received approval from the Center of Medicare & Medicaid Services (CMS) to pay the Fee-for-Service (FFS) Affordable Care Act (ACA) hospital access payments for the months of July through October. As previously reported, IHA has long contended that the FFS ACA access payments represent payments for dates of service for a prior period. IHA has been advised by HFS that after extensive discussions with CMS, the federal agency concurs and that the FFS ACA payments may be paid under the previously approved state plan for an additional four months.

HFS had previously posted the FFS ACA payment amounts for the months of May and June 2018. The July 2018 report will soon be posted and will be equal to the amounts paid in May and June. HFS will then post the final quarterly payment report based on dates of service between April and June 2018. This report will reflect the payments to be issued during the period July through October 2018. As a reminder, the FFS ACA payments are paid by the state directly to hospitals.

On June 28, HFS issued a provider notice regarding the June 2018 final reconciliation of the ACA assessment. This reconciliation represents the final installment of the tax associated with the ACA FFS payments to be issued between July and October 2018. HFS has mailed the remittance notices for the June 2018 ACA assessment adjustment to each hospital. The tax payment is due on July 20, 2018. The Department requests that hospitals remit this assessment payment separately from the fiscal year 2019 assessments.

Remittance notices for fiscal year 2019 new assessment program under the provisions of Public Act 100-0581 will be provided in a separate notice as soon as available.