For the purposes of this Part, the following definitions
apply:
"Acute care hospital" means a hospital that has been assigned
a CCN with the last four digits in the series 0001-0879 or 1300-1399 and has an
average length of a patient stay of 25 or fewer days. Multiple hospitals
operating under a single CCN are, for purposes of this Part, considered as a
single hospital.
"Children's hospital" means a hospital that predominately
treats individuals under the age of 21 and has been assigned a CMS
certification number with the last four digits in the series 3300-3399 or, in
the instance of a hospital that does not participate in Medicare, is licensed
as a pediatric hospital by the Illinois Department of Public Health.
"Coordinated care participating hospital" means a hospital
that is located in a geographic area of the State in which HFS mandates some or
all of the beneficiaries of the Medical Assistance Program residing in the area
to enroll in a care coordination program, as defined in
305 ILCS
5/5-30, that has entered into a contract to provide
hospital services to enrollees of the care coordination program; has not been
offered a contract by a care coordination plan that pays no less than HFS would
have paid on a fee-for-service (FFS) basis, but excluding disproportionate
share hospital adjustment payments or any other supplemental payment that HFS
pays directly; or is not licensed to serve the population mandated to enroll in
the care coordination program.
"CCN" means CMMS certification number, a six character
identification number assigned to CMMS Medicare and Medicaid providers
(formerly known as the Medicare/Medicaid provider number, the online survey,
certification and reporting (OSCAR) number, or the Medicare identification
number).
"CMMS" means the Centers for Medicare and Medicaid Services,
the organizational unit within the U.S. Department of Health and Human Services
responsible for overseeing the Medicaid program.
"Department" means the Department of Healthcare and Family
Services.
"Hospital" means any institution, place, building or agency,
public or private, whether organized for profit or not-for-profit, that
is:
located in Illinois and is subject to licensure by the
Illinois Department of Public Health under the Hospital Licensing Act [210 ILCS
85 ] or the University of Illinois Hospital Act [110 ILCS 330 ]; or
located in another state and meets all comparable conditions
and requirements of the Hospital Licensing Act in effect for the state in which
it is located.
"Medicaid" means medical assistance provided pursuant to
Title XIX of the federal Social Security Act, as implemented pursuant to
Article V of the Illinois Public Aid Code or a comparable law in another
state.
"Medicaid Managed Care Entity (MMCE) participating hospitals"
means a hospital that is located in a geographic area of the State in which HFS
offers enrollment with an MMCE as a voluntary option to beneficiaries of the
Medical Assistance Program and that has entered into a contract to provide
hospital services to enrollees of an MMCE.
"Medicare" means health insurance provided pursuant to Title
XVIII of the federal Social Security Act.
