Sec. 361.5. (a) “Unreimbursed costs”, for purposes of IC 16-21-6 and IC 16-21-9, means the costs a hospital incurs for providing services after subtracting payments received from any source for such services, including the following:

(1) Third party insurance payments.

Terms Used In Indiana Code 16-18-2-361.5

  • Charity: An agency, institution, or organization in existence and operating for the benefit of an indefinite number of persons and conducted for educational, religious, scientific, medical, or other beneficent purposes.
(2) Medicare payments.

(3) Medicaid payments.

(4) Medicare education reimbursements.

(5) State reimbursements for education.

(6) Payments from drug companies to pursue research.

(7) Grant funds for research.

(8) Disproportionate share payments.

     (b) For purposes of this definition, costs must be calculated by applying the aggregate cost to charge ratios for all hospital services derived from the hospital’s Medicare cost report to billed charges. Before January 1, 1997, for purposes of this definition, charitable contributions and grants to a hospital, including transfers from endowment or other funds controlled by the hospital or the hospital’s nonprofit supporting entities, shall not be subtracted from the costs of providing services for purposes of determining unreimbursed costs. Beginning January 1, 1997, for purposes of this definition, charitable contributions and grants to a hospital, including transfers from endowment or other funds controlled by the hospital or the hospital’s nonprofit supporting entities, shall not be subtracted from the costs of providing services for purposes of determining the unreimbursed costs of charity care and government sponsored indigent health care.

     (c) As used in this section, “government sponsored indigent health care” has the meaning set forth in IC 16-21-9-2.

     (d) As used in this section, “nonprofit supporting entity” means a nonprofit entity that is created by the hospital or the hospital’s parent entity to further the charitable purposes of the hospital and that is owned or controlled by the hospital or the hospital’s parent entity.

As added by P.L.94-1994, SEC.11.