Review Data in Rate Year 2019 Determination Letters

October 4, 2018


HFS Distribution of Rate Year 2019 DSH, MPA and MHVA Determination & Rates

Last week IHA sent a memo to hospital and health system CFOs and patient financial services staff to inform them that the Department of Healthcare and Family Services (HFS) had posted the Rate Year 2019 (October 1, 2018 – September 30, 2019) Disproportionate Share (DSH), Medicaid Percentage Adjustment (MPA), and Medicaid High Volume Adjustment (MHVA) determination and rates on its website. Click here for the HFS notice and click here for hospital notification letters.

During IHA’s review of the Rate Year 2019 hospital determination letters, staff have identified a number of significant swings in hospital Medicaid Inpatient Utilization Rates (MIURs). These variations may accurately reflect changes at your hospital, but we are encouraging all hospitals to carefully review the data contained in the letter. Also, hospitals should closely compare the Rate Year 2019 and Rate Year 2018 determinations, paying particular attention to the MIURs calculation and the rates if your hospital is eligible.

If your hospital believes that there are errors in the calculation, a formal appeal must be made in accordance with Section 148.310(b) and (f) of the 89 Illinois Administrative Code. All appeals must be made in writing no later than THIRTY (30) DAYS FROM THE DATE OF THIS LETTER for Rate Year 2019. APPEALS MUST BE SUBMITTED IN WRITING AND MUST BE RECEIVED OR POSTMARKED NO LATER THAN MONDAY OCTOBER 29, 2018. The Department will NOT ACCEPT hospital logs as supporting documentation for appeals.

If you have questions, please contact Joe Holler or Jo Ann Spoor.