- Critical Access or Rural Hospitals (as defined by ICTF rules) - within 90 days of notice
- All other hospitals - within 30 days of notice
If either type of hospital can demonstrate they are in financial distress, then repayment plans can be based on a hospital's proposal but limited to the following time period:
- Critical Access or Rural Hospitals - up to 6 months
- All other hospitals - up to 3 months
Financial Distress would be demonstrated by a hospital meeting any one of the following criteria:
- Any hospital who has less than 15 days cash or cash equivalents (Determined by comparing this amount: [most recent annual expenses available divided by 365 and multiplied by 15] to current [as of date of request] cash-on-hand or cash-equivalent amounts).
- Any hospital with Reserves equal zero (cash or bonds or CD's, etc).
- Any hospital who has lost money in operations two of last three years or last two years consecutively.
It will be contingent on the hospital to request a repayment plan, otherwise the standard 30 or 90 day periods will apply. For hospitals requesting an extension due to financial distress, the hospital will be required to complete a form indicating how they qualify under the financial distress provision, with an attestation by both the hospital's CEO and CFO as to the accuracy of the form.
Hospitals requesting an extension must agree to the following provisions: The Department may recover up to 10% of any supplemental UPL or DSH payment or up to 100% of any other settlement or judgment payment due to the hospital to accelerate repayment of debts owed to the Department.