No. HB 4019
Filed under Healthcare.
Compensation for Health Care Services for Inmates in Lake County; Limits compensation to health care provider & to hospital designated as trauma center that provide medical services for inmate housed in Lake County detention center if provider & hospital do not have contract with county to provide such services; limits compensation to entity that provides emergency medical transportation services for inmate housed in Lake County detention center if entity does not have contract with county to provide such services.
Plain English Summary
AI-GENERATEDIf a Lake County jail inmate needs medical care from a provider without a contract with the county, that provider's compensation is capped at 110% of the Medicare allowable rate.
A hospital that reported a negative operating margin the year before gets a higher ceiling, 125% of the Medicare rate, for the same uncontracted inmate care.
Trauma centers treating a designated trauma-alert inmate must be paid a flat 175% of the Medicare rate, the highest of the three tiers, if they lack a county contract.
Ambulance and air-ambulance providers face their own separate 110% cap for uncontracted inmate transportation. None of these caps apply to a hospital that Lake County itself operates.
AICompensation to a health care provider for any medical services to a Lake County jail inmate may not exceed 110 percent of the Medicare allowable rate if the provider has no county contract.
AIA health care provider that reported a negative operating margin the previous year to the state health care agency gets a higher cap, 125 percent of Medicare, instead of the base 110 percent.
AIA trauma center hospital treating a Lake County inmate designated a trauma alert victim must be paid exactly 175 percent of the Medicare rate if it has no county contract -- not a ceiling, a set rate.
AICompensation to an entity providing emergency medical transportation, including ambulance or air ambulance service, for a Lake County jail inmate may not exceed 110 percent of Medicare if it has no county contract.
AINone of these compensation caps apply to charges for medical services provided at a hospital that Lake County operates itself.
AIThe definition of 'health care provider' subject to these caps excludes a facility whose primary purpose is performing terminations of pregnancy, and excludes a physician's or dentist's private office.