Code of Massachusetts Regulations
114 CMR - DIVISION OF HEALTH CARE FINANCE AND POLICY
Title 114.1 CMR 40.00 - NON-ACUTE HOSPITAL PUBLICLY ASSISTED RATES OF PAYMENT AND THE FEE FOR RESIDENTIAL ALCOHOLISM TREATMENT PROGRAMS
Section 40.13 - Extraordinary Disproportionate Share Adjustment for State Owned Special Population Hospitals
Current through Register 1531, September 27, 2024
The Division shall determine for FY 1996 and succeeding years an extraordinary disproportionate share adjustment for all eligible state owned special population hospitals using the data and methodology described below.
(1) Data Sources. The Division shall use the RSC-403 report for the fiscal year two years prior to the fiscal year of the calculation of the disproportionate share adjustment to determine the cost, free care, charge, patient day, and net revenue amounts. If said RSC-403 report is not available, the Division shall use the most recent available previous RSC-403 report to estimate these variables. If the specified data source is unavailable, then the Division shall determine and use the best alternative data source.
(2) Determination of Eligibility.
(3) Determination of Payment. Except as provided in 114.1 CMR 40.10(2), for each state owned special population hospital determined eligible for the extraordinary disproportionate share adjustment under 114.1 CMR 40.13(2), the payment amount shall be equal to the estimated rate year unreimbursed cost of providing hospital services to Medicaid-eligible individuals and uninsured individuals, calculated as follows:
(4) Payments made pursuant to this section are subject to Health Care Financing Administration approval of state plan amendments incorporating this methodology.