il-v50i43-89-ill-adm-code-149: 89 Ill. Adm. Code 149 — Diagnosis Related Grouping (DRG) Prospective Payment System (PPS)

1) Heading of the Part: Diagnosis Related Grouping (DRG) Prospective Payment System (PPS) 2) Code Citation: 89 Ill. Adm. Code 149 3) Section Number: Proposed Action: 149.100 Amendment 4) Statutory Authority: Implementing and authorized by Articles III, IV, V, VI and VII and Section 12-13 of the Illinois Public Aid Code [305 ILCS 5/Arts. III, IV, V, VI and VII and 12-13]. 5) A Complete Description of the Subjects and Issues Involved: Pursuant to the FY 27 Medicaid Omnibus Bill, Public Act 104-0470, this proposed amendment to Rule 149 are as follows: The safety net policy adjustment factor tiered by MIUR is extended for calendar years 2027 and 2028. The safety net policy adjustment factor for low-volume safety net hospitals is extended for calendar years 2027 and 2028. The diagnosis-related group prospective payment system reimbursement process is clarifying required annual updates. This rulemaking would define excessive growth in outlier payments for the purposes of adjusting the outlier fixed loss threshold and require corresponding adjustments for calendar years 2027 and 2028. 6) Published studies or reports, and sources of underlying data, used to compose this rulemaking: None 7) Will this proposed rulemaking replace an emergency rule currently in effect? No 8) Does this rulemaking contain an automatic repeal date? No 9) Does this proposed amendment contain incorporations by reference? No 10) Are there any other proposed rulemakings pending on this Part? Yes Section Number: Proposed Action: Illinois Register Citation: 149.50 Amendment 50 Ill. Reg. 13414; September 11, 2026 11) Statement of Statewide Policy Objectives: This rulemaking does not affect units of local government. 12) Time, Place, and Manner in which interested persons may comment on this proposed rulemaking: Any interested parties may submit comments, data, views, or arguments concerning this proposed rulemaking. All comments must be in writing and should be addressed to: Chris Gange Acting General Counsel Illinois Department of Healthcare and Family Services 201 South Grand Avenue E., 3 Floor Springfield IL 62763-0002 217-782-1233 HFS.Rules@illinois.gov The Department requests the submission of written comments within 45 days after the publication of this Notice. The Department will consider all written comments it receives during the first notice period as required by Section 5-40 of the Illinois Administrative Procedure Act [5 ILCS 100/5-40]. 13) Initial Regulatory Flexibility Analysis: A) Description of the type of small business, not for profit corporations or small municipalities subject to the proposed amendment: None B) Description of the proposed reporting, bookkeeping and other procedures required for compliance with the amendment: None C) Description of the types of professional skills necessary for compliance: None 14) Small Business Economic Impact Analysis: None 15) Regulatory Agenda on which this rulemaking was summarized: July 2026 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES NOTICE OF PROPOSED AMENDMENT 16) Any other information or justification for the proposed rule or amendment that the agency believes would be helpful to the public regarding the proposed rule or amendment. For example, a discussion or analysis of the benefits of the proposed rule or amendment is projected to have on the Illinois public, consumers, investors or other similar groups: None The full text of the Proposed Amendment begins on the next page: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES NOTICE OF PROPOSED AMENDMENT TITLE 89: SOCIAL SERVICES CHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES SUBCHAPTER d: MEDICAL PROGRAMS PART 149 DIAGNOSIS RELATED GROUPING (DRG) PROSPECTIVE PAYMENT SYSTEM (PPS) Section 149.5 Diagnosis Related Grouping (DRG) Prospective Payment System (PPS) (Repealed) 149.10 Applicability of Other Provisions 149.25 General Provisions 149.50 Hospital Inpatient Services Subject to and Excluded from the DRG Prospective Payment System 149.75 Conditions for Payment Under the DRG Prospective Payment System 149.100 Methodology for Determining DRG PPS Payment Rates 149.105 Payment For Outlier Cases 149.125 Special Treatment of Certain Facilities (Repealed) 149.140 Methodology for Determining Primary Care Access Health Care Education Payments (Repealed) 149.150 Payments to Hospitals Under the DRG Prospective Payment System (Repealed) 149.175 Payments to Contracting Hospitals (Repealed) 149.200 Admitting and Clinical Privileges (Repealed) 149.205 Inpatient Hospital Care or Services by Non-Contracting Hospitals Eligible for Payment (Repealed) 149.225 Payment to Hospitals for Inpatient Services or Care not Provided under the ICARE Program (Repealed) 149.250 Contract Monitoring (Repealed) 149.275 Transfer of Recipients (Repealed) 149.300 Validity of Contracts (Repealed) 149.305 Termination of ICARE Contracts (Repealed) 149.325 Hospital Services Procurement Advisory Board (Repealed) AUTHORITY: Implementing and authorized by Articles III, IV, V, VI and VII and Section 12- 13 of the Illinois Public Aid Code [305 ILCS 5/Arts. III, IV, V, VI and VII and 12-13]. SOURCE: Recodified from 89 Ill. Adm. Code 140.940 through 140.972 at 12 Ill. Reg. 7401; amended at 12 Ill. Reg. 12095, effective July 15, 1988; amended at 13 Ill. Reg. 554, effective January 1, 1989; amended at 13 Ill. Reg. 15070, effective September 15, 1989; amended at 15 Ill. Reg. 1826, effective January 28, 1991; emergency amendment at 15 Ill. Reg. 16308, effective November 1, 1991, for a maximum of 150 days; amended at 16 Ill. Reg. 6195, effective March 27, 1992; emergency amendment at 16 Ill. Reg. 11937, effective July 10, 1992, for a maximum of 150 days; emergency amendment at 16 Ill. Reg. 14733, effective October 1, 1992, for a maximum of 150 days; amended at 16 Ill. Reg. 19868, effective December 7, 1992; amended at 17 Ill. Reg. 3217, effective March 1, 1993; emergency amendment at 17 Ill. Reg. 17275, effective October 1, 1993, for a maximum of 150 days; amended at 18 Ill. Reg. 3378, effective February 25, 1994; amended at 19 Ill. Reg. 10674, effective July 1, 1995; amended at 21 Ill. Reg. 2238, effective February 3, 1997; emergency amendment at 22 Ill. Reg. 13064, effective July 1, 1998, for a maximum of 150 days; amended at 22 Ill. Reg. 19866, effective October 30, 1998; amended at 25 Ill. Reg. 8775, effective July 1, 2001; amended at 26 Ill. Reg. 13676, effective September 3, 2002; emergency amendment at 27 Ill. Reg. 11080, effective July 1, 2003, for a maximum of 150 days; amended at 27 Ill. Reg. 18872, effective November 26, 2003; amended at 28 Ill. Reg. 2836, effective February 1, 2004; amended at 38 Ill. Reg. 15477, effective July 2, 2014; amended at 41 Ill. Reg. 1059, effective January 19, 2017; emergency amendment at 42 Ill. Reg. 13876, effective July 2, 2018, for a maximum of 150 days; amended at 42 Ill. Reg. 22533, effective November 28, 2018; amended at 49 Ill. Reg. 2090, effective February 10, 2025; amended at 50 Ill. Reg. ______, effective ____________. Section 149.100 Methodology for Determining DRG PPS Payment Rates Effective for dates of discharge on or after July 1, 2014: a) Inpatient hospital services that are not excluded from the DRG PPS pursuant to Section 149.50(b) shall be reimbursed as determined in this Section. b) Total DRG PPS Payment. Under the DRG PPS, services to inpatients who are: 1) Discharges shall be paid pursuant to subsection (c). 2) Transfers shall be paid pursuant to subsection (g). 3) The total payment for an inpatient stay will equal the sum of the payment determined in subsection (c) or (g), as applicable, and any applicable adjustments to payment specified in 89 Ill. Adm. Code 148.290. c) DRG PPS Payment for Discharges. The reimbursement to hospitals for inpatient services based on discharges shall be the product, rounded to the nearest hundredth, of the following: 1) The greater of: A) 1.0000; or B) highest policy adjustment factor, as defined in subsection (f), for which the inpatient stay qualifies. 2) The sum of the DRG base payment, as defined in subsection (d), and any applicable outlier adjustment, as determined in Section 149.105, for which the claim qualifies. d) For in-state (as defined in 89 Ill. Adm. Code 148.140), non-Large Public Hospitals as defined in 89 Ill. Adm. Code 148.25, the DRG base payment for a claim shall be the product, rounded to the nearest hundredth, of: 1) The DRG weighting factor of the DRG and SOI, to which the inpatient stay was assigned by the DRG grouper. 2) The DRG base rate, equal to the sum of: A) The product, rounded to the nearest hundredth, of the Medicare IPPS labor share percentage, Medicare inpatient prospective payment system (IPPS) wage index, statewide standardized amount and graduate medical education (GME) factor. B) The product, rounded to the nearest hundredth, of the Medicare IPPS non-labor share percentage, the statewide standardized amount and the GME factor. 3) Effective July 1, 2018, for out-of-state, cost reporting hospitals, the DRG base payment for a claim shall be the product, rounded to the nearest hundredth, of: A) The DRG weighting factor of the DRG and SOI, to which the inpatient stay was assigned by the DRG grouper; and B) The DRG base rate, equal to the sum of: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES NOTICE OF PROPOSED AMENDMENT i) The product, rounded to the nearest hundredth, of the Medicare IPPS labor share percentage, Medicare IPPS wage index, the out-of-state standardized amount and the GME factor. ii) The product, rounded to the nearest hundredth, of the Medicare IPPS non-labor share percentage, the out-of-state standardized amount and the GME factor. e) Medicare IPPS Wage Index. For purposes of this Section, the Medicare IPPS wage index is determined based on: 1) For Medicare IPPS hospitals that are in-state or are out-of-state medical assistance cost reporting hospitals, the wage index is based on the Medicare inpatient prospective payment system post-reclass wage index effective at the beginning of the federal fiscal year starting three months prior to the calendar year during which the discharge occurred; except, for the calendar year beginning January 1, 2014, the wage index is based on the Medicare IPPS hospital post-reclass wage index effective October 1, 2012. 2) For in-state non-Medicare IPPS hospitals and out-of-state non-medical assistance cost reporting hospitals, the wage index is based on the Medicare inpatient prospective payment system wage index for the hospital's Medicare CBSA effective at the beginning of the federal fiscal year starting three months prior to the calendar year during which the discharge occurred; except, for the calendar year beginning January 1, 2014, the wage index is based on the Medicare IPPS wage index for the hospital's Medicare CBSA effective October 1, 2012. f) Policy Adjustments. Claims for inpatient stays that meet certain criteria will qualify for further adjustments to payment. 1) Transplantation Services A) Policy adjustment factor: 2.11. B) Qualifying Criteria DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES NOTICE OF PROPOSED AMENDMENT i) The hospital meets all requirements to perform transplantation services, including but not limited to those detailed in 89 Ill. Adm. Code 148.82. ii) The claim has been grouped to one of the following DRGs: 001 Liver transplant. 002 Heart and/or lung transplant. 003 Bone marrow transplant. 006 Pancreas transplant. 440 Kidney transplant. 2) Trauma Services A) Policy adjustment factor: i) 2.9100, if the hospital is a level I trauma center. ii) 2.7600, if the hospital is a level II trauma center. B) Criteria: i) Hospital is recognized by the Department of Public Health as a level I or II trauma center on the date of admission. ii) The claim has been grouped to one of the following DRG: 020 Craniotomy for trauma. 055 Head trauma, with coma lasting more than one hour or no coma. 056 Brain contusion/laceration and complicated skull fracture, coma less than one hour or no coma. 057 Concussion, closed skull fracture not otherwise specified, uncomplicated intracranial injury, coma less than one hour or no coma. 135 Major chest and respiratory trauma. 308 Hip and femur procedures for trauma, except joint replacement. DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES NOTICE OF PROPOSED AMENDMENT 384 Contusion, open wound and other trauma to skin and subcutaneous tissue. 841 Extensive third degree burns with skin graft, as of July 1, 2018. 842 Full thickness burns with graft, as of July 1, 2018. 843 Extensive burns without skin graft, as of July 1, 2018. 844 Partial thickness burns with or without graft, as of July 1, 2018. 910 Craniotomy for multiple significant trauma. 911 Extensive abdominal/thoracic procedures for multiple significant trauma. 912 Musculoskeletal and other procedures for multiple significant trauma. 930 Multiple significant trauma, without operating room procedure. 3) Perinatal Services A) Policy adjustment factor: i) 1.3500, if the DRG to which the claim is grouped has an SOI of 1. ii) 1.4300, if the DRG to which the claim is grouped has an SOI of 2. iii) 1.4100, if the DRG to which the claim is grouped has an SOI of 3. iv) 1.5400, if the DRG to which the claim is grouped has an SOI of 4. B) Criteria: i) Hospital was recognized by the Department of Public Health as a level III perinatal center on the date of admission. Effective July 1, 2018, hospital was recognized DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES NOTICE OF PROPOSED AMENDMENT by the Department of Public Health as a level II or II+ or III perinatal center on the date of admission. ii) The claim has been grouped to one of the following major diagnostic categories (MDC): 14 Pregnancy, childbirth and puerperium. 15 Newborn and other neonates. 4) Safety Net A) Policy adjustment factor: Effective for dates of service January 1, 2024 through June 30, 2024, $210 per general acute and psychiatric care day, excluding Medicare dual eligible days. B) Qualifying criteria: safety-net hospital defined in 305 ILCS 5/5- 5e.1. C) Effective for dates of service on or after July 1, 2024, through December 31, 2025, excluding Medicare dual eligible days, based on the MIUR determination effective October 1, 2023, the safety net policy adjustment factor shall be: i) $425 per general acute and psychiatric day for safety net hospitals with an applicable MIUR equal to or greater than 70%. ii) $300 per general acute and psychiatric day for safety net hospitals with an applicable MIUR equal to or greater than 50% and less than 70%. iii) $225 per general acute and psychiatric day for safety net hospitals with an applicable MIUR equal to or greater than 40% and less than 50%. iv) $210 per general acute and psychiatric day for safety net hospitals with an applicable MIUR less than 40%. DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES NOTICE OF PROPOSED AMENDMENT D) Effective for dates of service on or after January 1, 2026 through December 31, 20282026, qualification for the safety net policy adjustment factor shall be redetermined each January using the MIUR determination effective October 1 three months prior to the payment year, 2025 and the Safety Net policy adjustment factors in subsections (f)(4)(C)(i) through (f)(4)(C)(iii) in this Section shall be adjusted each January 1, 2026 by applying a uniform factor to spend an approximate amount of $50,000,000 in the paymentcalendar year 2026 using the state fiscal year ending 18 months prior to the payment year (SFY 2025 data for CY 2027 payment year) 2024 general acute care days and psychiatric days, excluding Medicare dual eligible days, for all qualifying hospitals as the basis. E) Effective for dates of service on or after July 1, 2024, through December 31, 2026, the safety net policy adjustment factor in subsections (f)(4)(C) and (D) shall be increased by $200 per day for low volume safety net hospitals. Effective for dates of service on or after January 1, 2027 through December 31, 2028, the safety net policy adjustment factor in subsections (f)(4)(C) and (D) shall be increased each January 1, by the lesser of $200 or the amount derived by dividing $30,000,000 by the number of inpatient acute care and psychiatric care days, excluding Medicare dual eligible days, for all qualifying low volume safety net hospitals, using SFY 2025 data as a base for setting the calendar year 2027 rates and SFY 2026 data as a base for setting the calendar year 2028 rates. i) For dates of service July 1, 2024 through December 31, 2025, low volume is defined as a safety net hospital providing less than 11,000 inpatient acute care and psychiatric care days, excluding Medicare dual eligible days, during state fiscal year 2022 for admissions received by the Department prior to October 1, 2023. ii) For dates of service January 1, 2026 through December 31, 2026, low volume is defined as a safety net hospital providing less than 11,000 inpatient acute care and psychiatric care days, excluding Medicare dual eligible DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES NOTICE OF PROPOSED AMENDMENT days, during state fiscal year 2023 for admissions received by the Department prior to October 1, 2024. iii) For dates of service January 1, 2027 through December 31, 2027, low volume is defined as a safety net hospital providing less than 11,000 inpatient acute care and psychiatric care days, excluding Medicare dual eligible days, during state fiscal year 2024 for admissions received by the Department prior to October 1, 2025. iv) For dates of service January 1, 2028 through December 31, 2028, low volume is defined as a safety net hospital providing less than 11,000 inpatient acute care and psychiatric care days, excluding Medicare dual eligible days, during state fiscal year 2025 for admissions received by the Department prior to October 1, 2026. g) DRG PPS Payment for Transfers. The reimbursement to hospitals for inpatient services provided to transfers shall be the lesser of: 1) The amount that would have been paid pursuant to subsection (c) had the inpatient been a discharge; or 2) The product, rounded to the nearest hundredth, of the following: A) The quotient resulting from dividing the amount that would have been paid pursuant to subsection (c) had the inpatient been a discharge by the DRG average length of stay for the DRG to which the inpatient claim has been assigned. B) The length of stay plus the constant 1.0. h) Annual updatesUpdates to DRG PPS Reimbursement. Each January, the Department shall update the rate components as described in this subsection, the outlier fixed loss threshold, if applicable, and adjust the statewide standardized amount in accordance with this subsection. The Department may annually review the components listed in subsection (c) and make adjustments as needed. The DRG Grouper shall be updated at least triennially and no more frequently than annually. 1) The following rate components shall be updated each January per the rule language cited for each component: A) Medicare IPPS labor share percentage as defined in subsection (i); B) Medicare inpatient prospective payment system (IPPS) wage index as defined in subsection (e); and C) Medicare IPPS outlier cost-to-charge ratio as defined in 149.105(b). 2) The preliminary statewide standardized amount shall be initially set to the average amount as the basis for the DRG base rate so that total simulated DRG PPS payments from the inpatient base period claims data with updated rate components listed in (h)(1) above, without the GME factor adjustments, is equal to the sum of inpatient base period claims data allowed amount. 3) The outlier fixed loss threshold shall be adjusted if the simulated outlier payments using the preliminary statewide standardized amount are found to be excessive. Excessive is defined as outlier payments exceeding 29.5% of the total simulated allowed amount for calendar year 2027 and 28% of the total simulated allowed amount for calendar year 2028. 4) The final statewide standardized amount shall be set to the average amount as the basis for the DRG base rate such that total simulated DRG PPS payments from the inpatient base period claims data with updated rate components and, as applicable, the adjusted fixed loss threshold, without the GME factor adjustments is equal to the sum of inpatient base period claims data allowed amount. i) Definitions "Allocated static payments" means the adjustment payments made to the hospital pursuant to 89 Ill. Adm. Code 148.105, 148.115, 148.126, 148.295, 148.296 and 148.298 during State fiscal year 2011, excluding those payments that continue after July 1, 2014, pursuant to the methodologies outlined in rule as of February 21, 2014 (see https://www.illinois.gov/hfs/medicalproviders/hospitals/ DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES NOTICE OF PROPOSED AMENDMENT hospitalratereform/Pages/default.aspx), as determined by the Department, allocated to general acute services based on the ratio of general acute claim charges to total inpatient claim charges determined using inpatient base period claims data. "Allowed amounts", effective January 1, 2024, means the calculated fee schedule amount prior to any adjustment for secondary payer amounts for inpatient priced claims via the DRG-PPS, except Medicare dual eligible claims which are included up to the amount of medical assistance liability on the claim. "Discharge" means a hospital inpatient that: has been formally released from the hospital, except when the patient is a transfer; or died in the hospital. "DRG" means diagnosis related group, as defined in the DRG grouper, based on the principal diagnosis, surgical procedure used, age of patient, etc. "DRG average length of stay" means, for each DRG and SOI combination, the national arithmetic mean length of stay for that combination rounded to the nearest tenth, as published by Solventum3M Health Information Systems for the DRG grouper. "DRG grouper" means the version of the All Patient Refined Diagnosis Related Grouping (APR-DRG) software distributed by Solventum3M Health Information Systems being used by the Department for pricing fee-for-service hospital inpatient acute care claims and is updated at least every 43 years in accordance with 305 ILCS 5/14-12(a), (b) and (e). "DRG PPS" means the DRG prospective payment system described in this Part. "DRG weighting factor" means each DRG and SOI combination shall equal the product, rounded to the nearest ten-thousandth, of the national weighting factor for that combination, as published by Solventum3M Health Information Systems for the DRG grouper and the Illinois experience adjustment. DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES NOTICE OF PROPOSED AMENDMENT "GME factor" means the Graduate Medical Education factor applied to major teaching hospitals, as defined in 89 Ill. Adm. Code 148.25(h). Simulated payments under the new inpatient system with GME factor adjustments shall be $3 million greater than simulated payments under the new inpatient system would have been without the GME factor adjustments, using inpatient base period paid claims data. "Illinois experience adjustment" means: for the calendar year beginning January 1, 2014, a quotient, computed by dividing the constant 1.0000 by the arithmetic mean 3M APR-DRG national weighting factors of claims for inpatient stays subject to reimbursement under the DRG PPS using inpatient base period paid claims data, rounded to the nearest ten-thousandth; for subsequent calendar years, the factor applied to Solventum3M APR- DRG national weighting factors, when updating DRG grouper versions determined such that the arithmetic mean DRG weighting factor under the new DRG grouper version is equal to the arithmetic mean DRG weighting factor under the prior DRG grouper version using inpatient base period claims data. "Inpatient base period claims data" means: Prior to July 1, 2018, State fiscal year 2011 inpatient medical assistance fee-for-service paid claims data, excluding Medicare dual eligible claims, for DRG PPS payment for services provided in State fiscal years 2015, 2016 and 2017; for subsequent dates of service, the most recently available adjudicated 12 months of inpatient paid claims data to be identified by the Department. Effective July 1, 2018, State fiscal year 2015 inpatient medical assistance claims data allowed amounts, for DRG PPS payment for services provided in State fiscal years 2019 and 2020 for subsequent dates of service, the most recently available adjudicated 12 months of inpatient paid claims data to be identified by the Department. DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES NOTICE OF PROPOSED AMENDMENT "Inpatient stay" means a formal admission into a hospital, pursuant to the order of a licensed practitioner permitted by the state in which the hospital is located to admit patients to a hospital that requires at least one overnight stay. "Length of stay" means the number of days the patient was an inpatient in the hospital, with the day the patient became a discharge or transfer not counting toward the length of stay. "Medical assistance" means one of the programs administered by the Department that provides health care coverage to Illinois residents. "Medicare CBSA" means the Core-Based Statistical Areas for a hospital's location effective in the Medicare inpatient prospective payment system at the beginning of the federal fiscal year starting three months prior to the calendar year during which the discharge occurred. "Medicare IPPS labor share percentage" means the Medicare inpatient prospective payment system operating standardized amount labor share percentage for the federal fiscal year ending three months prior to the calendar year during which the discharge occurred.; except, for the calendar year beginning January 1, 2014, the labor share percentage in the Medicare inpatient prospective payment system for the federal fiscal year beginning October 1, 2012, which is 0.6880 for a hospital with a Medicare IPPS wage index greater than 1.0 or 0.6200 for all other hospitals. "Medicare IPPS non-labor share" means the difference of 1.0 and the Medicare IPPS labor share percentage. "MDC" means major diagnostic category – group of similar DRGs, such as all those affecting a given organ system of the body. "Out-of-state standardized amount", effective July 1, 2018, means, for cost- reporting hospitals located outside of Illinois that are not included in the in-state standardized amount definition, the average amount as the basis for the DRG base rate established by the Department, such that simulated DRG PPS allowed amounts, without PA 97-689 reductions or GME factor adjustments, using general acute hospital inpatient based period claims data, are equal to the sum of inpatient based period claims data allowed amounts. DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES NOTICE OF PROPOSED AMENDMENT "SOI" means one of four subclasses of each DRG, as published by Solventum3M Health Information Systems for the DRG grouper that relate to severity of illness (the extent of physiologic decompensation or organ system loss of function experienced by the patient) and risk of (the likelihood of) dying. "Statewide standardized amount" means, for all Illinois hospitals and out-of-state hospitals that are designated a level I pediatric trauma center or a level I trauma center by the Illinois Department of Public Health as of December 1, 2017, the average amount as the basis for the DRG base rate established by the Department of simulated DRG PPS payments from the inpatient base period claims data such that the total simulated DRG PPS payments, without the GME factor adjustments is equal to the sum of inpatient based period claims data allowed amount. Effective January 1, 2024, the "statewide standardized amount", as established for January 1, 2024, is increased by 10%. "Transfer" means a hospital inpatient that has been placed in the care of another hospital, except that a transfer does not include an inpatient claim that has been assigned to DRG 580 (Neonate, transferred, less than five days old, not born here) or 581 (Neonate, transferred, less than five days old, born here). (Source: Amended at 50 Ill. Reg. ______, effective ____________) DEPARTMENT OF REVENUE NOTICE OF PROPOSED AMENDMENTS