Missouri Code of State Regulations
Title 13 - DEPARTMENT OF SOCIAL SERVICES
Division 70 - MO HealthNet Division
Chapter 10 - Nursing Home Program
Section 13 CSR 70-10.160 - Public/Private Long-Term Care Services and Supports Partnership Supplemental Payment to Nursing Facilities

Universal Citation: 13 MO Code of State Regs 70-10.160

Current through Register Vol. 49, No. 18, September 16, 2024

PURPOSE: This amendment allows supplement payments to public nursing facilities that have qualified IGT agreements with the Department of Social Services.

(1) Effective for dates of service on or after April 1, 2012, through June 30, 2013, supplemental payments will be made as set forth in subsections (1)(A)-(1)(D) in each following calendar quarter from the Long-Term Support Upper Payment Limit (UPL) Fund to qualifying private and public nursing facilities for services rendered during the quarter on or after April 1, 2012 through June 30, 2013. Maximum payments to all qualifying private and public nursing facilities shall not exceed the upper payment limit defined in 42 CFR 447.272 in each state fiscal year.

(2) Effective for dates of service beginning July 1, 2013, Nursing Facility UPL Payments shall be made as set forth below in subsections (2)(A)-(2)(C). Maximum aggregate payments to all qualifying nursing facilities shall not exceed the upper payment limit defined in 42 CFR 447.272 in each state fiscal year.

(A) An annual UPL Payment shall be made at the end of each state fiscal year (SFY) to qualifying nursing facilities.

(B) Qualifying Criteria. Public nursing facilities that have executed an agreement with the department are eligible for a UPL Payment and shall be referred to as qualifying nursing facilities. In addition, to qualify for the UPL Payment, each nursing facility must be enrolled in the Medicaid program at the time the UPL payments are calculated and made.

(C) Reimbursement Methodology. The annual UPL Payment will be made to qualifying nursing facilities based on each facility's unreimbursed costs determined from the facility's second prior year Medicaid cost report, subject to the Medicare Upper Payment Limit.

*Original authority: 208.201, RSMo 1987, amended 2007.

Disclaimer: These regulations may not be the most recent version. Missouri may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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