Hawaii Administrative Rules
Title 17 - DEPARTMENT OF HUMAN SERVICES
Department of Human Services
Chapter 1739 - AUTHORIZATION, PAYMENT, AND CLAIMS IN THE FEE-FOR-SERVICE MEDICAL ASSISTANCE PROGRAM
Subchapter 3 - PROSPECTIVE PAYMENT FOR ACUTE CARE SERVICES
Section 17-1739-63 - Calculation of base year prospective rates for classification I - nonpsychiatric services
Universal Citation: HI Admin Rules 17-1739-63
Current through February, 2024
(a) A base per diem rate for nonpsychiatric services for classification I facilities shall be established using the following general methodology:
(1) Deduct the capital related costs
allocated to non-psychiatric services on the base year cost report;
(2) Calculate nonpsychiatric inpatient
medicaid facility costs and days for all facilities in classification I by
subtracting the facility's psychiatric costs and days for routine, special
care, and ancillary services as specified in section 17-1739-62 from the
facility's total allowable medicaid inpatient costs and days for routine,
special care, and ancillary services as derived from the cost report and as
calculated in section 17-1739-61; and
(3) Total the resulting costs, excluding
capital related costs, and days for routine, special care, and ancillary
services and achieve a facility-specific medicaid inpatient nonpsychiatric cost
per day by dividing total nonpsychiatric medicaid costs by total nonpsychiatric
inpatient medicaid days.
(b) The classification I per diem rate ceiling for nonpsychiatric services shall be calculated as follows:
(1) Total the costs, excluding capital
related costs, and days for all nonpsychiatric services for all facilities in
classification I, as identified in subsection (a);
(2) Divide total nonpsychiatric inpatient
costs calculated in paragraph (1) by total nonpsychiatric inpatient days for
all facilities in classification I; and
(3) Multiply the result of paragraph (2) by
the nonpsychiatric classification I ceiling factor (one hundred twenty per
cent) published annually by the department. This result shall be the
classification I per diem rate ceiling for nonpsychiatric facilities.
(c) The prospective payment rate for classification I facilities shall equal the lesser of either the facility-specific per diem rates or the classification I per diem rate ceiling for nonpsychiatric inpatient services.
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