Section 2807-W. High need indigent care adjustment pool

Funds allocated
  pursuant to paragraph (p) of subdivision  one  of  section  twenty-eight
  hundred  seven-v  of  this article, shall be deposited as authorized and
  used for the purpose of making medicaid disproportionate share  payments
  of  up  to eighty-two million dollars on an annualized basis pursuant to
  subdivision twenty-one of section twenty-eight hundred seven-c  of  this
  article,  for  the  period  January  first,  two  thousand through March
  thirty-first, two thousand ten, in accordance with the following:
    1. From the funds in the pool each year:    (a)  Each  eligible  rural
  hospital  shall  receive  one  hundred  forty  thousand  dollars  on  an
  annualized basis for the periods January  first,  two  thousand  through
  December  thirty-first, two thousand ten, provided as a disproportionate
  share payment; provided, however, that if such payment pursuant to  this
  paragraph  exceeds a hospital's applicable disproportionate share limit,
  then the total amount in excess of such limit shall  be  provided  as  a
  nondisproportionate  share  payment in the form of a grant directly from
  this pool without allocation to  the  special  revenue  funds  -  other,
  indigent care fund - 068, or any successor fund or account, and provided
  further  that  payments  for  periods  on  and  after January first, two
  thousand nine shall be subject to the provisions of  subdivision  five-a
  of section twenty-eight hundred seven-k of this article;
    (b)  Each  such  hospital  shall  also receive an amount calculated by
  multiplying the facility's uncompensated care need  by  the  appropriate
  percentage from the following scale based on hospital rankings developed
  in  accordance  with each eligible rural hospital's weight as defined by
  this section.
 
                 Rank                      Percentage Coverage of
                                           Uncompensated Care Need
 
                  1-9                             60.0%
                 10-17                            52.5%
                 18-25                            45.0%
                 26-33                            37.5%
                 34-41                            30.0%
                 42-49                            22.5%
                 50-57                            15.0%
                   58+                             7.5%
 
    For purposes of calculating the distribution  amount  to  an  eligible
  rural  hospital  which  has  merged  with  another  hospital on or after
  December thirty-first, nineteen hundred ninety-nine, and continues to be
  an eligible rural hospital in accordance  with  paragraph  (c)  of  this
  subdivision,  such merged facility's uncompensated care need pursuant to
  this paragraph shall be calculated from data provided  in  the  eligible
  rural hospital's institutional cost report filed for the rate period two
  years  prior  to  the  distribution  period,  or  if  such report is not
  required for such rural hospital, the distribution amount shall be based
  upon the last institutional cost report required to  be  filed  by  such
  rural hospital.
    (c)  "Eligible  rural hospital", as used in this section, shall mean a
  general hospital that as  of  December  thirty-first,  nineteen  hundred
  ninety-nine  or  thereafter,  was  classified  as  a  rural hospital for
  purposes of determining  payment  for  inpatient  services  provided  to
  beneficiaries  of  title  XVIII  of  the  federal  social  security  act
  (medicare) or under state regulations,  or  a  general  hospital,  which
  during  the  same  time  period, had a service area which has an average
  population of less than one  hundred  seventy-five  persons  per  square

  mile,  or  a  general  hospital  which  has  a service area which has an
  average population of less than two  hundred  persons  per  square  mile
  measured  as  population  density by zip code. The average population of
  the  service area is calculated by multiplying annual patient discharges
  by the population density per square mile of the county of origin or zip
  code as applicable for each patient  discharge  and  dividing  by  total
  discharges.   Annual   patient  discharges  shall  be  determined  using
  discharge data for the  nineteen  hundred  ninety-seven  rate  year,  as
  reported   to  the  commissioner  by  October  first,  nineteen  hundred
  ninety-eight. Population density shall be  determined  utilizing  United
  States  census  bureau  data  for  nineteen  hundred ninety-seven. If an
  eligible rural hospital merges with  another  general  hospital,  on  or
  after  December  thirty-first,  nineteen  hundred  ninety-nine,  and the
  merger results in separate facilities operating under a single  facility
  operating certificate, such eligible rural hospital shall continue to be
  a  separate eligible rural hospital for purposes of this subdivision and
  payments provided in accordance with this section shall be made  to  the
  merged  entity;  provided,  however, that payments shall only be made to
  the merged entity if such separate eligible rural hospital continues  to
  provide  inpatient  and/or  outpatient  hospital  services  at  the same
  location at which it operated prior to the merger. If an eligible  rural
  hospital  merges  with  another  general  hospital  on or after December
  thirty-first, nineteen hundred ninety-nine, and the  merger  results  in
  such  rural  hospital  continuing  to  operate under a separate facility
  operating certificate, such  rural  hospital  will  continue  to  be  an
  eligible  rural  hospital  after  the  merger;  provided,  however, that
  payments shall only be made to such  rural  hospital  if  such  eligible
  rural hospital continues to provide inpatient and/or outpatient hospital
  services  at  the  same  location  at  which it is operated prior to the
  merger.
    (d) "Eligible rural hospital weight", as used in this  section,  shall
  mean the result of adding, for each eligible rural hospital:
    (i) The eligible rural hospital's targeted need, as defined in section
  twenty-eight  hundred  seven-k  of this article, minus the mean targeted
  need for all eligible rural hospitals, divided by the standard deviation
  of the targeted need of all eligible rural hospitals; and
    (ii) The mean number of beds of all eligible rural hospitals minus the
  number of beds for an  individual  hospital,  divided  by  the  standard
  deviation of the number of beds for all eligible rural hospitals.
    2. From the funds in the pool each year, thirty-six million dollars on
  an  annualized basis for the periods January first, two thousand through
  December thirty-first, two thousand ten, of the funds not distributed in
  accordance with subdivision one of this section, shall be distributed in
  accordance with the formula set forth  in  subdivision  six  of  section
  twenty-eight  hundred  seven-k  of this article, provided, however, that
  payments for periods on and after January first, two thousand nine shall
  be  subject  to  the  provisions  of  subdivision  five-a   of   section
  twenty-eight hundred seven-k of this article.
    3.  From the funds in the pool each year, any funds not distributed in
  accordance with subdivision  one  or  two  of  this  section,  shall  be
  distributed in accordance with the formula set forth in paragraph (b) of
  subdivision  four  of  section  twenty-eight  hundred  seven-k  of  this
  article.
    4. In order for a general hospital to be eligible  to  participate  in
  the  distribution  of  funds  pursuant  to  this  section,  such general
  hospital must be in compliance with the provisions of subdivisions nine,
  ten and twelve of section twenty-eight hundred seven-k of this article.