{"data":{"id":"us-ky/krs-205.639","jurisdiction":"us-ky","citation":"KRS 205.639","heading":"Definitions for KRS 205.639 to 205.640.","body":"As used in KRS 205.639 to 205.640, unless the context otherwise requires:\n(1) \"Acute care hospital\" means an acute care hospital licensed under KRS 216B.0425\nexcept that it shall not include a critical access hospital, private psychiatric hospital,\nor state mental hospital;\n(2) \"Comprehensive physical rehabilitation hospital\" means an in -state freestanding\nrehabilitation hospital that also meets the criteria for an inpatient rehabilitation\nfacility under 42 C.F.R. sec. 412.29;\n(3) \"Critical access hospital\"  means a hospital licensed as a critical access hospital\nunder KRS 216.380;\n(4) \"Department\" means the Department for Medicaid Services;\n(5) \"Essential hospital\" means an acute care hospital that qualifies as a Medicaid\ninpatient utilization rate (MIUR) ho spital, a low -income utilization rate (LIUR)\nhospital, or a critical access hospital;\n(6) \"Final disproportionate share hospital payment\" or \"final DSH payment\" means the\nstate fiscal year DSH payment for a hospital determined by the department using the\nhospital's examined Medicaid DSH survey and which is reconciled to the hospital's\ninitial state fiscal year DSH payment and limited to the hospital's hospital -specific\nDSH limit;\n(7) \"Hospital-specific disproportionate share hospital limit\" or \"Hospital -specific DSH\nlimit\" means the limitation required under 42 U.S.C. sec. 1396r -4(g) and\ncorresponding regulations that a DSH payment may not exceed a hospital's\nuncompensated costs of providing inpatient hospital and outpatient hospital services\nto Medicaid-eligible individuals and uninsured individuals;\n(8) \"Initial disproportionate share hospital payment\" or \"Initial DSH payment\" means\nthe state fiscal year DSH payment made to a hospital by the department using data,\nsubject to limited review, from the hospita l's Medicaid DSH survey or proxy\ninformation and which is subject to reconciliation when the hospital's Medicaid\nDSH survey is examined;\n(9) \"Long-term acute hospital\" means an in-state hospital that is certified as a long-term\ncare hospital under 42 U.S.C. sec. 1395ww(d)(1)(B)(iv);\n(10) \"Low-income utilization rate\" or \"LIUR\" means, for a hospital, the sum of:\n(a) A fraction expressed as a percentage, rounded to the nearest hundredth:\n1. The numerator of which is the sum for a period of the total Medicaid\nrevenues paid to the hospital for patient services, regardless of whether\nthe services were furnished on a fee -for-service basis or through a\nmanaged care entity, and the amount of cash subsidies for patient\nservices received directly from state and local governments; and\n2. The denominator of which is the total amount of revenues of the hospital\nfor patient services, including the amount of cash subsidies, in the\nperiod; and\n(b) A fraction expressed as a percentage rounded to the nearest hundredth:\n1. The numerator of which is the total amount of the hospital's charges for\ninpatient hospital services which are attributable to charity care in a\nperiod, less the portion of any cash subsidies described in subparagraph\n1. of paragraph (a) of this subsection  in the period reasonably\nattributable to inpatient hospital services, and which shall not include\ncontractual allowances and discounts other than for indigent patients not\neligible for medical assistance; and\n2. The denominator of which is the total amoun t of the hospital's charges\nfor inpatient hospital services in the hospital in the period;\n(11) \"Low-income utilization rate hospital\" or \"LIUR hospital\" means an acute care\nhospital whose low -income utilization rate exceeds one hundred twenty percent\n(120%) of the state average low -income utilization rate rounded to the nearest\nhundredth for all acute care hospitals, critical access hospitals, private psychiatric\nhospitals, and university hospitals combined, as reported on the hospitals' Medicaid\nDSH surveys;\n(12) \"Medicaid disproportionate share hospital survey\" or \"Medicaid DSH survey\"\nmeans the report required to be submitted by each hospital receiving Medicaid\ndisproportionate share payments pursuant to 42 C.F.R. sec. 447.299;\n(13) \"Medicaid uncompensat ed care\" means the same as in 42 C.F.R. sec.\n447.299(c)(11);\n(14) \"Medicaid inpatient utilization rate\" or \"MIUR\" means, for a hospital, a fraction\nexpressed as a percentage rounded to the nearest hundredth for which the numerator\nshall be the number of in -state and out -of-state inpatient Medicaid days where\nMedicaid is the primary payor, covered under fee-for-service and managed care, and\nfor which the denominator shall be the total number of inpatient days for the\nhospital as reported on the hospital's Me dicaid DSH survey. However, for a\npediatric teaching hospital, as defined in KRS 205.565, the calculation shall exclude\nfrom the numerator and the denominator the hospital's inpatient Medicaid days\nutilized in the calculation of an intensity operating allo wance (IOA) payment.\nSupplemental information will be requested to support the IOA days included in the\nMedicaid DSH survey submission;\n(15) \"Medicaid inpatient utilization rate hospital\" or \"MIUR hospital\" means an acute\ncare hospital whose MIUR equals or  exceeds one (1) standard deviation above the\nmean MIUR rounded to the nearest hundredth for all acute care hospitals, critical\naccess hospitals, private psychiatric hospitals, and university hospitals combined, as\ndetermined from the hospitals' Medicaid DSH surveys;\n(16) \"Paid claims listing\" or \"PCL\" means a report created for a hospital by the\ndepartment, or by a Medicaid managed care organization using the same format as\nthe department, with claim level payment information prescribed by the department\nin sufficient detail to permit reconciliation with the hospital's internal data for each\nMedicaid recipient or managed care enrollee having a discharge date or service date,\nas applicable, for inpatient or outpatient services within a hospital's fiscal year;\n(17) \"Private psychiatric hospital\" means a psychiatric hospital licensed under KRS\nChapter 216B that is not a state mental hospital and is not a distinct part unit of a\nlicensed acute care hospital or operated under the same provider number as a\nlicensed acute care hospital;\n(18) \"State mental hospital\" means a psychiatric hospital licensed under KRS Chapter\n216B that is owned or operated by the Commonwealth;\n(19) \"Total uncompensated care costs\" means the same as in 42 C.F.R. sec.\n447.299(c)(16);\n(20) \"Uninsured uncompensated care costs\" means the same as in 42 C.F.R. sec.\n447.299(c)(15); and\n(21) \"University hospital\" means a state university teaching hospital, owned or operated\nby either the University of Kentucky School of Medicine or the University o f\nLouisville School of Medicine.","path":["KRS Chapter 205"],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=47702","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:52:04Z","sha256":"8f99d41eefdad7ad8283822221aedffcadead0b8768429934aced8d974d0f62b","source_id":"us-ky","stale":false,"prev":"us-ky/krs-205.638","next":"us-ky/krs-205.640"},"notice":"GroundRules: Original legal text. Not legal advice."}