Current through Register Vol. 50, No. 9, March 1, 2024
RELATES TO:
42 U.S.C.
1396a(a)(13)(A),
42 U.S.C.
1396a(a)(30)(A), 42 C.F.R.
Part 413,
42
C.F.R. 447.204
NECESSITY, FUNCTION, AND CONFORMITY: The Cabinet for Health and
Family Services, Department for Medicaid Services has responsibility to
administer the Medicaid Program.
KRS
205.520(3) authorizes the
cabinet, by administrative regulation, to comply with any requirement that may
be imposed, or opportunity presented, by federal law to qualify for federal
Medicaid funds. This administrative regulation establishes the definitions for
907 KAR Chapter 18.
Section 1.
Definitions.
(1) "Allowable cost" means that
portion of a facility's cost which may be allowed by the department for
reimbursement purposes.
(2)
"Ancillary service" means an ancillary service as established in
907
KAR 1:023.
(3) "Capital costs" means capital costs as
established in
42 C.F.R.
413.130 through 157.
(4) "Cost report" means a copy of the cost
report that a VA NF submits to the Medicare program.
(5) "Department" means the Department for
Medicaid Services or its designee.
(6) "Federal financial participation" is
defined by
42 C.F.R.
400.203.
(7) "Global Insight Index" means an
indication of changes in health care costs from year to year developed by
Global Insights Index.
(8) "Pro
forma cost data" means estimated cost data for a specific future period of
time.
(9) "Prospective payment
rate" means a payment rate for services based on allowable costs and other
factors.
(10) "Recipient" is
defined by
KRS
205.8451(9).
(11) "Regular part-time employee" means an
employee who works part-time:
(a) On a
continual basis; and
(b) Not on a
short-term or temporary basis.
(12) "State fiscal year" means the twelve
(12) month period beginning on July 1 of one year and ending on June 30 of the
following year.
(13) "Upper payment
limit" means an amount of reimbursement that:
(a) Equates to a Veterans Affairs nursing
facility's Medicaid-allowable cost; and
(b) Does not exceed the limit established in
42 C.F.R.
447.272.
(14) "VA NF" means a nursing facility that
meets the requirements of
907
KAR 18:005, Section 1.
STATUTORY AUTHORITY:
KRS
194A.030(2),
194A.050(1),
205.520(3)
