Hospital Care Assurance Program – 2002

The Hospital Care Assurance Program (HCAP) is Ohio's version of the federally required Disproportionate Share Hospital program. HCAP compensates hospitals who provide a disproportionate share of care to indigent patients (Medicaid consumers, people below poverty, and people without health insurance).

The assessment and model calculations for the FFY 2002 Hospital Care Assurance Program have been completed. The data for the model is taken from interim settled Medicaid Cost Reports for SFY 2001. For most providers this would be the year ending 12/31/2000 or 6/30/2001

The FFY 2002 HCAP program distributes $562.3 million to providers. Of that amount, $231.8 million was collected in the form of assessments to providers, with the balance of the funds provided by the Federal Government. The assessment and payment amounts for FFY 2002 may be downloaded by clicking on the link below.

HCAP2002 (xls). Updated on 9/3/02. Most spreadsheet programs should be able to open this file.

DISCLAIMER: The Department of Medicaid has taken appropriate measures to ensure that the file you are getting matches the actual assessments and payments for this year's program. However, it is possible that variations may occur in the process of converting the file between spreadsheet applications. By downloading this file you are accepting it as is and agree that the Department is not responsible for any errors or omissions. In the event that there are differences between this file and the actual or payments, the version of the model maintained by the department shall supercede this file.

Due to outstanding issues with certain hospital providers, the amount generated by hospital assessments is insufficient to make eligible payments of $562,357,188.00 to all hospitals. Hence, the Bureau of Health Plan Policy has invoked OAC 5101:3-2-09 (J)(4) and reduced the amount of payments to all hospitals by 0.264125%. Thus, each hospital eligible for a payment, shall receive payments that are 0.264125% less than the payment rates shown in the attached payment schedule. When funds to make the full payment amount are eventually available, we shall make additional payments accordingly.

Each year, in an effort to ensure that valid data is used, the Department conducts data reviews on a select number of hospitals. The review process requires that selected providers send to the Department the required backup documentation to support the amounts shown on Schedule F of the Medicaid Cost Report (JFS 02930). The results of the data reviews are compiled into the HCAP Data Review Final Summary Report.

Based on the 2002 HCAP data reviews, there were a few areas in which hospitals have demonstrated improvement from the 2001 HCAP program year. No instances of inappropriate collection of patient payments were noted, most hospitals have written procedures regarding the implementation of the HCAP program, and all hospitals reported having posted signs. The data reviews continue to be an important tool for ODJFS to not only verify the accuracy of HCAP data, but to also raise awareness of problems Ohio hospitals are having with implementation of the program.

There are several areas in which there is still room for improvement in HCAP reporting. Patient logs need to clearly show which patients are inpatient or outpatient, as well as which category the patient falls in; Disability Assistance, Uncompensated Above or Uncompensated Below, Insurance or No Insurance. The Department has prepared a sample of an acceptable patient log [names are fictitious]. Please note the manner in which the records are consecutively numbered.

Another area requiring improvement is the data collected from the HCAP application. The income of the patient [or patient's family] as well as the family size are critical elements in determining if the patient is eligible for the program. The Department has prepared a sample application which collects the minimum amount of information required for the program. Providers are free to use the application or to modify it to fit their needs.

Additionally, there is room for improvement in documenting the services written-off to HCAP. Services written-off to HCAP must be supported by medical records and must be basic, medically necessary hospital-level services. Finally, it is important to note that services provided to Medicaid recipients cannot be written-off to HCAP, and should not be included in the logs. There continues to be a significant level of confusion between Disability Assistance and Medicaid eligibility. Please refer to the HCAP Data Review Final Summary Report for a more detailed discussion regarding all of the areas noted here as needing improvement.

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