1. (1) If DIH audits a hospital's records to determine the correct discharges for the assessment for a hospital required to file a Medicare cost report, but the hospital fails to provide its Medicare cost report within the timeline required, DIH shall fine the hospital 5% of its annual calculated assessment. The fine is payable within 30 days of invoice.
2. (2) If DIH audits a hospital's records to determine the correct discharges for the assessment because the hospital does not file a Medicare cost report and did not submit its discharges and supporting documentation within the timeline required, DIH shall fine the hospital 5% of its annual calculated assessment. The fine is payable within 30 days of invoice.
3. (3) If a hospital fails to fully pay its assessment on or before the due date, DIH shall fine the hospital 5% of its quarterly calculated assessment. The fine is payable within 30 days of invoice.
4. (4) On the last day of each quarter, if a hospital has any unpaid assessment or penalty, DIH shall fine the hospital 5% of the unpaid amount. The fine is payable within 30 days of invoice.

5. (5)(a) If a hospital fails to pay its assessment on or before the due date, DIH shall suspend payments to the hospital until the assessment and any fines or penalties are paid in full.

   1. (b) DIH shall provide written notice before withholding payments.
   2. (c) When DIH rescinds withholding of payments to a provider, it will, without notice, resume payments according to the regular claims payment cycle.

KEY: Medicaid

Date of Last Change: June 19, 2025

Notice of Continuation: April 12, 2025

Authorizing, and Implemented or Interpreted Law: 26B-1-213; 26B-3-108; 26B-3-7