OHA - The Ohio Hospital Association

The Hospital Care Assurance Program (HCAP) is the Ohio Department of Job and Family Services' mechanism for meeting the federal requirement to provide additional payments to hospitals which provide a disproportionate share of uncompensated services to the indigent and uninsured.

Provider assessments levied against all acute care and freestanding hospitals in Ohio generate the basic funding source for this program.  These assessment dollars are pooled with matching federal Medicaid Disproportionate Share Hospital (DSH) funds.  This pool is then distributed back to the hospitals based on a formula that uses Medicaid costs and uncompensated care costs as proxies for measuring the relative level of each hospital's indigent care services to statewide indigent care services.

For more information, please visit our most recent Frequently Asked Questions about HCAP rules, eligibility, and procedures.

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Current HCAP News

October 25: FAQ 5.2 has been clarified and expanded.  Please see the FAQ page for more details.

September 27: Three new FAQs have been added (2.2c, 2.6b, and 2.11), and three others have been updated (5.1, 5.2, and 7.7b).  Please go to the FAQ page to see what's new.

September 19: Though ODJFS did not present a new distribution model at today's public hearing on HCAP 2008 as announced, two OHA representatives, Senior Vice President John Callender and Manager of Health Policy Ryan Biles, testified at the hearing on behalf of Ohio hospitals today. OHA outlined the importance of protecting HCAP to hospitals, which count on the federal funding to allow them to continue to provide free care to individuals under the poverty line, withstand losses from Medicaid shortfalls and provide uncompensated care to the uninsured.  For more information, please see John Callender's Testimony and Ryan Biles' Testimony (Attachment 1; Attachment 2).

September 18: A message from ODJFS: 

JFS has resolved the issues which caused a large number of the HCAP payments to be made as warrants rather than EFT. This spreadsheet indicates which type of payment a hospital may expect for the payment scheduled for September 28th. The payment types are based on the type of payment which has been received in the past. For those which indicate "EFT", no further action is required by the hospital. If the payment type is "CHK," the next HCAP payment will be a warrant.

If you would rather receive an EFT, you should first contact the JFS HCAP staff at 614.466.6420. They can check to see if an EFT option is already available for a specific hospital. If you have never had EFT and which to establish EFT payment, you should complete this form and submit it to the state. Submitting this form now, however, does not guarantee that your next HCAP payment will be by EFT. Please contact the Office of Budget and Management directly at 614.466.5670 with any questions about the form.

September 13: More on the OAKS implementation issues...ODJFS has informed OHA that due to the implementation of the new system, some EFT routing information was not transferred, and the affected hospitals had their 1st HCAP payments physically mailed to them.  If your hospital has still not received its 1st HCAP payment, please check to see if it has arrived in the mail.  If you do not receive the payment by tomorrow, please contact Ryan Biles at 614.221.7614. 

For hospitals that would prefer to receive the 2nd HCAP payment this year via EFT, as well as all future HCAP payments, please contact Aggie Howard at the Office of Budget and Management (OBM) at 614.466.5670 to set up (or re-set up) your account information with the state.

September 7: ODJFS has just announced that the 1st HCAP distributions will not go out on Monday as scheduled.  Instead, the 1st payments should reach hospitals on Tuesday.  The one day delay is due to the implementation of the new Ohio Administrative Knowledge System (OAKS), and should not affect the timing of the 2nd assessment or 2nd payment.

August 23: An error involving a 2007 HCAP cost report entry for a supplemental upper payment limit payment was discovered and corrected today.  The correction does not affect the assessment rate or assessment/payment schedule.  However, the correction does entail an aggregate redistribution of approximately $240,000 statewide, so please check the model again for your final, final numbers.  We apologize for any confusion.

August 21: The Joint Committee on Agency Rule Review (JCARR) yesterday approved the 2007 HCAP assessment rate rule, thereby setting the stage for $326.4 million in federal funding to be distributed to Ohio hospitals over the coming weeks. ODJFS has issued final assessment notices to all hospitals that participate in HCAP, including the due dates of assessments and expected payment dates. The Final 2007 HCAP Assessment and Distribution model, along with two model descriptions (first, second) and OBRA cap analysis are now available. 

As in years past, ODJFS will collect assessments and return payments to hospitals in two equal installments. ODJFS requires all assessments and payments be made via electronic fund transfer (EFT). Hospitals can ensure they are set up for EFTs by contacting the Office of Budget and Management (OBM) at 614.466.5670. The dates for the assessments and distributions are as follows:

  • First ½ Assessment due             Aug. 30
  • First ½ Payment sent                Sept. 10
  • Second ½ Assessment due       Sept. 17
  • Second ½ Payment sent           Sept. 28

Finally, the data verification process for HCAP 2008 has already started and hospitals should soon receive a certified letter from ODJFS and OHA’s HCAP data verification package, which includes a summary of the data that will be used to determine HCAP 2008 payments. ODJFS sends letters out in batches of 10-20 hospitals, so this process will take a few months to complete.  Hospitals have only 30 days from the receipt of the certified letter from ODJFS in which to correct any errors in the as-filed Medicaid cost reports. 

More HCAP news...

About HCAP

Background information on the Hospital Care Assurance Program including summaries, historical spreadsheets, current timelines, and other resources.

Calculations & Models

The 2000, 2001, 2002, and 2003 HCAP models along with explanations of the most current model and important calculations associated with it.

Advocacy Efforts

Highlights of federal efforts to protect and expand the size of the Hospital Care Assurance Program.  Up-to-the-minute issue updates and information on how to aid in the advocacy efforts.

OHA Contacts

Who to contact at the Ohio Hospital Association if you have further questions regarding HCAP.

Useful Links

Resources from around the World Wide Web related to the Hospital Care Assurance program.

© 2001-2007 OHA. Last updated December 05, 2007.
Please direct comments, corrections or additions to: oha@ohanet.org 614.221.7614.