Administrative Rules of Montana
Department 37 - PUBLIC HEALTH AND HUMAN SERVICES
Chapter 37.86 - MEDICAID PRIMARY CARE SERVICES
Subchapter 37.86.29 - Inpatient Hospital Services
Rule 37.86.2912 - INPATIENT HOSPITAL PROSPECTIVE REIMBURSEMENT, CAPITAL-RELATED COSTS

(1) Capital expenses are included within the APR-DRG base payment and will not be paid separately to PPS facilities and will not be cost settled.

(2) The interim payment made to CAHs is based on the hospital-specific cost-to-charge ratio and includes capital costs. For dates of service January 1, 2018 through June 30, 2018, the interim payment made is based on the hospital-specific cost-to-charge ratio, less 2.99%, and includes capital costs. For dates of service on or after July 1, 2018, the interim payment made is based on the hospital-specific cost-to-charge ratio, and includes capital costs.

(3) The department adopts and incorporates by reference 42 CFR 412.113(a) and (b), and will calculate as provided in (1) and (2) capital-related costs that are allowable under Medicare cost reimbursement principles as established in 42 CFR 412.113(a) and (b) (March 29, 1985). Copies of the cited regulation may be obtained from the Department of Public Health and Human Services, Health Resources Division, 1400 Broadway, P.O. Box 202951, Helena, MT 59620-2951.