§146.840. Reimbursement of Birth Center Services

 

a)         Facility services provided by a birth center located in Cook County will be reimbursed at the lower of billed charges or 75 percent of the average facility payment rate made to a hospital located in Cook County for an uncomplicated vaginal birth.

 

b)         Facility services provided by a birth center located outside of Cook County will be reimbursed at the lower of billed charges or 75 percent of the statewide average facility payment rate made to a hospital located outside of Cook County for an uncomplicated vaginal birth.

 

c)         Observation services will be reimbursed at the lower of billed charges or at 75 percent of the rate established by the Department for the number of hours of observation billed pursuant to 89 Ill. Adm. Code 148.140(b)(1)(D) as reflected at http://www2.illinois.gov/hfs/PublicInvolvement/hospitalratereform/Pages/

Rules.aspx through dates of service on June 30, 2014.  Effective for dates of service on or after July 1, 2014, observation services will be reimbursed at the lower of billed charges or $53.56 for 1 hour or more.

 

d)         Transfer fees for a birth center located in Cook County will be reimbursed at the lower of billed charges or 15 percent of the average facility payment rate made to a hospital located in Cook County for an uncomplicated vaginal birth. 

 

e)         Transfer fees for a birth center located outside of Cook County will be reimbursed at the lower of billed charges or 15 percent of the statewide average facility payment rate made to a hospital located outside of Cook County for an uncomplicated vaginal birth.

 

(Source:  Amended at 38 Ill. Reg. 15152, effective July 2, 2014)