CHAPTER 20. INDIGENT CARE TRUST FUND
IC 12-15-20
Chapter 20. Indigent Care Trust Fund
IC 12-15-20-1
Fund defined
Sec. 1. As used in this chapter, "fund" refers to the Medicaidindigent care trust fund established by this chapter.
As added by P.L.2-1992, SEC.9.
IC 12-15-20-2
Establishment of fund; payments from fund; priority
Sec. 2. The Medicaid indigent care trust fund is established to paythe non-federal share of the following:
(1) Enhanced disproportionate share payments to providersunder IC 12-15-19-1.
(2) Subject to subdivision (8), disproportionate share paymentsto providers under IC 12-15-19-2.1.
(3) Medicaid payments for pregnant women described inIC 12-15-2-13 and infants and children described inIC 12-15-2-14.
(4) Municipal disproportionate share payments to providersunder IC 12-15-19-8.
(5) Payments to hospitals under IC 12-15-15-9.
(6) Payments to hospitals under IC 12-15-15-9.5.
(7) Payments, funding, and transfers as otherwise provided inclauses (8)(D), (8)(F), and (8)(G).
(8) Of the intergovernmental transfers deposited into theMedicaid indigent care trust fund, the following apply:
(A) The entirety of the intergovernmental transfers depositedinto the Medicaid indigent care trust fund for state fiscalyears ending on or before June 30, 2000, shall be used tofund the state's share of the disproportionate share paymentsto providers under IC 12-15-19-2.1.
(B) Of the intergovernmental transfers deposited into theMedicaid indigent care trust fund for the state fiscal yearending June 30, 2001, an amount equal to one hundredpercent (100%) of the total intergovernmental transfersdeposited into the Medicaid indigent care trust fund for thestate fiscal year beginning July 1, 1998, and ending June 30,1999, shall be used to fund the state's share ofdisproportionate share payments to providers underIC 12-15-19-2.1. The remainder of the intergovernmentaltransfers, if any, for the state fiscal year shall be used to fundthe state's share of additional Medicaid payments tohospitals licensed under IC 16-21 pursuant to a methodologyadopted by the office.
(C) Of the intergovernmental transfers deposited into theMedicaid indigent care trust fund, for state fiscal yearsbeginning July 1, 2001, and July 1, 2002, an amount equalto: (i) one hundred percent (100%) of the totalintergovernmental transfers deposited into the Medicaidindigent care trust fund for the state fiscal year beginningJuly 1, 1998; minus
(ii) an amount equal to the amount deposited into theMedicaid indigent care trust fund under IC 12-15-15-9(d)for the state fiscal years beginning July 1, 2001, and July1, 2002;
shall be used to fund the state's share of disproportionateshare payments to providers under IC 12-15-19-2.1. Theremainder of the intergovernmental transfers, if any, must beused to fund the state's share of additional Medicaidpayments to hospitals licensed under IC 16-21 pursuant to amethodology adopted by the office.
(D) The intergovernmental transfers, which shall includeamounts transferred under IC 12-16-7.5-4.5, deposited intothe Medicaid indigent care trust fund and the certificationsof public expenditures deemed to be made to the medicaidindigent care trust fund, for the state fiscal years ending afterJune 30, 2005, but before July 1, 2007, shall be used, indescending order of priority, as follows:
(i) As provided in clause (B) of STEP THREE ofIC 12-16-7.5-4.5(b)(1) and clause (B) of STEP THREE ofIC 12-16-7.5-4.5(b)(2), to fund the amount to betransferred to the office.
(ii) As provided in clause (C) of STEP THREE ofIC 12-16-7.5-4.5(b)(1) and clause (C) of STEP THREE ofIC 12-16-7.5-4.5(b)(2), to fund the non-federal share of thepayments made under IC 12-15-15-9 and IC 12-15-15-9.5.
(iii) To fund the non-federal share of the payments madeunder IC 12-15-15-1.1, IC 12-15-15-1.3, andIC 12-15-19-8.
(iv) As provided under clause (A) of STEP THREE ofIC 12-16-7.5-4.5(b)(1) and clause (A) of STEP THREE ofIC 12-16-7.5-4.5(b)(2), for the payment to be made underclause (A) of STEP FIVE of IC 12-15-15-1.5(b).
(v) As provided under STEP FOUR ofIC 12-16-7.5-4.5(b)(1) and STEP FOUR ofIC 12-16-7.5-4.5(b)(2), to fund the payments to be madeunder clause (B) of STEP FIVE of IC 12-15-15-1.5(b).
(vi) To fund, in an order of priority determined by theoffice to best use the available non-federal share, theprograms listed in clause (H).
(E) For state fiscal years ending after June 30, 2007, the totalamount of intergovernmental transfers used to fund thenon-federal share of payments to hospitals underIC 12-15-15-9 and IC 12-15-15-9.5 shall not exceed theamount provided in clause (G)(ii).
(F) As provided in clause (D), for the following:
(i) Each state fiscal year ending after June 30, 2003, but
before July 1, 2005, an amount equal to the amountcalculated under STEP THREE of the following formulashall be transferred to the office:
STEP ONE: Calculate the product of thirty-five milliondollars ($35,000,000) multiplied by the federal medicalassistance percentage for federal fiscal year 2003.
STEP TWO: Calculate the sum of the amounts, if any,reasonably estimated by the office to be transferred orotherwise made available to the office for the state fiscalyear, and the amounts, if any, actually transferred orotherwise made available to the office for the state fiscalyear, under arrangements whereby the office and a hospitallicensed under IC 16-21-2 agree that an amount transferredor otherwise made available to the office by the hospital oron behalf of the hospital shall be included in the calculationunder this STEP.
STEP THREE: Calculate the amount by which the productcalculated under STEP ONE exceeds the sum calculatedunder STEP TWO.
(ii) The state fiscal years ending after June 30, 2005, butbefore July 1, 2007, an amount equal to thirty milliondollars ($30,000,000) shall be transferred to the office.
(G) Subject to IC 12-15-20.7-2(b), for each state fiscal yearending after June 30, 2007, the total amount in the Medicaidindigent care trust fund, including the amount ofintergovernmental transfers of funds transferred, and theamounts of certifications of expenditures eligible for federalfinancial participation deemed to be transferred, to theMedicaid indigent care trust fund, shall be used to fund thefollowing:
(i) Thirty million dollars ($30,000,000) transferred to theoffice for the Medicaid budget.
(ii) An amount not to exceed the non-federal share ofpayments to hospitals under IC 12-15-15-9 andIC 12-15-15-9.5.
(iii) An amount not to exceed the non-federal share ofpayments to hospitals made under IC 12-15-15-1.1 andIC 12-15-15-1.3.
(iv) An amount not to exceed the non-federal share ofdisproportionate share payments to hospitals underIC 12-15-19-8.
(v) An amount not to exceed the non-federal share ofpayments to hospitals under clause (A) of STEP FIVE ofIC 12-15-15-1.5(c).
(vi) An amount not to exceed the non-federal share ofMedicaid safety-net payments.
(vii) An amount not to exceed the non-federal share ofpayments to hospitals made under clauses (C) or (D) ofSTEP FIVE of IC 12-15-15-1.5(c).
(viii) An amount not to exceed the non-federal share of
payments to hospitals made under clause (F) of STEPFIVE of IC 12-15-15-1.5(c).
(ix) An amount not to exceed the non-federal share ofdisproportionate share payments to hospitals underIC 12-15-19-2.1.
(x) If additional funds are available after making paymentsunder items (i) through (ix), to fund other Medicaidsupplemental payments for hospitals approved by theoffice and included in the Medicaid state plan.
(H) For purposes of clause (D)(vi), the office shall fund thefollowing:
(i) An amount equal to the non-federal share of thepayments to the hospital that is eligible under this item, forpayments made under clause (C) of STEP FIVE ofIC 12-15-15-1.5(b) under an agreement with the office,Medicaid safety-net payments and any payment madeunder IC 12-15-19-2.1. The amount of the payments to thehospital under this item shall be equal to one hundredpercent (100%) of the hospital's hospital-specific limit forstate fiscal year 2005, when the payments are combinedwith payments made under IC 12-15-15-9,IC 12-15-15-9.5, and clause (B) of STEP FIVE ofIC 12-15-15-1.5(b) for a state fiscal year. A hospital iseligible under this item if the hospital was eligible forMedicaid disproportionate share hospital payments for thestate fiscal year ending June 30, 1998, the hospitalreceived a Medicaid disproportionate share payment underIC 12-15-19-2.1 for state fiscal years 2001, 2002, 2003,and 2004, and the hospital merged two (2) hospitals undera single Medicaid provider number, effective January 1,2004.
(ii) An amount equal to the non-federal share of paymentsto hospitals that are eligible under this item, for paymentsmade under clause (C) of STEP FIVE ofIC 12-15-15-1.5(b) under an agreement with the office,Medicaid safety-net payments, and any payment madeunder IC 12-15-19-2.1. The amount of payments to eachhospital under this item shall be equal to one hundredpercent (100%) of the hospital's hospital-specific limit forstate fiscal year 2004, when the payments are combinedwith payments made to the hospital under IC 12-15-15-9,IC 12-15-15-9.5, and clause (B) of STEP FIVE ofIC 12-15-15-1.5(b) for a state fiscal year. A hospital iseligible under this item if the hospital did not receive apayment under item (i), the hospital has less than sixtythousand (60,000) Medicaid inpatient days annually, thehospital either was eligible for Medicaid disproportionateshare hospital payments for the state fiscal year endingJune 30, 1998 or the hospital met the office's Medicaiddisproportionate share payment criteria based on state
fiscal year 1998 data and received a Medicaiddisproportionate share payment for the state fiscal yearending June 30, 2001, and the hospital received aMedicaid disproportionate share payment underIC 12-15-19-2.1 for state fiscal years 2001, 2002, 2003,and 2004.
(iii) Subject to IC 12-15-19-6, an amount not less than thenon-federal share of Medicaid safety-net payments inaccordance with the Medicaid state plan.
(iv) An amount not less than the non-federal share ofpayments made under clause (C) of STEP FIVE ofIC 12-15-15-1.5(b) under an agreement with the office toa hospital having sixty thousand (60,000) Medicaidinpatient days annually.
(v) An amount not less than the non-federal share ofMedicaid disproportionate share payments for hospitalseligible under this item, and made under IC 12-15-19-6and the approved Medicaid state plan. A hospital iseligible for a payment under this item if the hospital iseligible for payments under IC 12-15-19-2.1.
(vi) If additional funds remain after the payments madeunder (i) through (v), payments approved by the office andunder the Medicaid state plan, to fund the non-federalshare of other Medicaid supplemental payments forhospitals.
As added by P.L.2-1992, SEC.9. Amended by P.L.27-1992, SEC.23;P.L.24-1997, SEC.50; P.L.126-1998, SEC.15; P.L.273-1999,SEC.174; P.L.113-2000, SEC.19; P.L.283-2001, SEC.26;P.L.1-2002, SEC.53; P.L.120-2002, SEC.17; P.L.255-2003, SEC.22;P.L.212-2007, SEC.10; P.L.218-2007, SEC.20.
IC 12-15-20-3
Expenses of administration
Sec. 3. The expenses of administering the fund shall be paid frommoney in the fund.
As added by P.L.2-1992, SEC.9.
IC 12-15-20-4
Investment of fund money
Sec. 4. (a) The treasurer of state shall invest the money in the fundnot currently needed to meet the obligations of the fund in the samemanner as other public funds may be invested.
(b) Interest that accrues from investments shall be deposited in thefund.
As added by P.L.2-1992, SEC.9.
IC 12-15-20-5
Records; balance in fund; investment earnings
Sec. 5. The office shall maintain records that show the amount ofmoney in the fund and the amount of investment earnings on that
amount.
As added by P.L.2-1992, SEC.9. Amended by P.L.27-1992, SEC.24.
IC 12-15-20-6
Money not to revert to general fund
Sec. 6. Money in the fund at the end of a state fiscal year does notrevert to the state general fund.
As added by P.L.2-1992, SEC.9.
IC 12-15-20-7
Use of fund money; availability of matching federal financialparticipation
Sec. 7. Money in the fund may only be used for the purposeslisted in section 2 of this chapter to the extent that federal financialparticipation under Medicaid is available to match the state money.
As added by P.L.2-1992, SEC.9.
IC 12-15-20-8
Repealed
(Repealed by P.L.27-1992, SEC.30.)