Current through Register Vol. 49, No. 13, September 23, 2024
Subpart 1.
Determination of relative values.
To determine the relative values of the diagnostic categories
the department shall:
A. Select
medical assistance claims for Minnesota and local trade area hospitals with
admission dates from each hospital's base year.
B. Exclude the claims and charges in subitems
(1) to (7):
(1) Medicare crossover
claims;
(2) claims paid on a
transfer rate per day according to part
9500.1128, subpart
2, item C;
(3) inpatient hospital services for which
medical assistance payment was not made;
(4) inpatient hospital claims paid to a
long-term care hospital;
(5)
inpatient hospital services not covered by the medical assistance program on
October 1 prior to a rebased rate year;
(6) inpatient hospital charges for noncovered
days calculated as the ratio of noncovered days to total days multiplied by
charges; and
(7) inpatient hospital
services paid under part
9500.1128, subpart
2, item E.
C. Combine claims into the
admission that generated the claim according to part
9500.1128, subpart 4.
D. Determine operating costs for each
hospital admission in item C using each hospital's base year data according to
subitems (1) to (5).
(1) Determine the
operating cost of accommodation services by multiplying the number of
accommodation service inpatient days by that accommodation service operating
cost per diem and add the products of all accommodation services.
(2) Determine the operating cost of each
ancillary service by multiplying the ancillary charges by that ancillary
operating cost-to-charge ratio and add the products of all ancillary services.
An ancillary operating cost-to-charge ratio will be adjusted for certified
registered nurse anesthetist costs and charges according to the hospital's
election under part
9500.1105, subpart
1, item A, subitem
(2).
(3) Determine the operating
cost of services rendered by interns and residents not in an approved teaching
program by multiplying the number of accommodation service inpatient days in
subitem (1) by that teaching program accommodation service per diem and add the
products of all teaching program accommodation services.
(4) Add subitems (1) to (3).
(5) Multiply the result of subitem (4) by the
hospital cost index that corresponds to the hospital's fiscal year end in part
9500.1120, subpart
2, item B.
E. Assign each admission and
operating cost identified in item D, subitem (5), to the appropriate program or
specialty group and diagnostic category according to part
9500.1100, subparts 20a to 20e and
20g.
F. Determine the mean cost per
admission within each program and the rehabilitation distinct part specialty
group for the program and rehabilitation distinct part specialty group
admissions identified in item E by dividing the sum of the operating costs by
the total number of admissions.
G.
Determine the mean cost per admission within each program and rehabilitation
distinct part specialty group diagnostic category identified in item E by
dividing the sum of the operating costs in each diagnostic category by the
total number of admissions in each diagnostic category.
H. Determine the relative value for each
diagnostic category by dividing item G by the corresponding result of item F
within each program and the rehabilitation distinct part specialty group and
round the quotient to five decimal places.
I. Determine the mean length of stay within
each program and rehabilitation distinct part diagnostic category identified in
item E by dividing the total number of inpatient service days in each
diagnostic category by the total number of admissions in that diagnostic
category and round the quotient to two decimal places.
J. Determine the day outlier trim point for
each program and rehabilitation distinct part diagnostic category and round to
whole days.
Subp. 2.
Redetermination of relative values.
The department shall reassign the program and specialty group
diagnostic category composition in part
9500.1100, subparts 20a to 20g,
after notice of the change in the State Register and a 30-day comment period.
The relative values in this part and adjusted base year operating costs in part
9500.1115 and
9500.1116 must be redetermined
when changes are made to part
9500.1100, subparts 20a to
20g.
Subp. 3. [Repealed, 18
SR 1115]