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 37.86.2931 - ROUTINE DISPROPORTIONATE SHARE HOSPITAL
Universal Citation: MT Admin Rules 37.86.2931
Current through Register Vol. 18, September 20, 2024
(1) A hospital is deemed a routine disproportionate share hospital if:
(a) it
has a Medicaid inpatient utilization rate of at least one standard deviation
above the mean Medicaid inpatient utilization rate for all hospitals receiving
Medicaid payments in Montana or a low income utilization rate exceeding 20%;
and
(b) it has a Medicaid
inpatient utilization rate of at least 1%.
(2) Urban hospitals must have at least two obstetricians with staff privileges who have agreed to provide obstetric services to Medicaid patients. Rural hospitals must have at least two physicians with staff privileges to perform nonemergent obstetric procedures who have agreed to provide obstetric services to Medicaid recipients.
(3) This rule does not apply to hospitals which:
(a) serve inpatients who are
predominantly individuals under 18 years of age; or
(b) do not offer nonemergent obstetric
services as of December 21, 1987.
AUTH: 2-4-201, 53-2-201, 53-6-113, MCA; IMP: 2-4-201, 53-2-201, 53-6-101, 53-6-111, 53-6-113, 53-6-149, MCA
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