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 37.86.2935 - CALCULATING LOW INCOME UTILIZATION RATE, FOR ROUTINE DISPROPORTIONATE SHARE HOSPITALS
Universal Citation: MT Admin Rules 37.86.2935
Current through Register Vol. 18, September 20, 2024
(1) The low income utilization rate is used to determine whether a hospital is deemed a routine disproportionate share hospital. The percentage rate is computed as follows:
(a) LIUR=((A + B)/C) + (D/E) where:
(i) "LIUR" is the low income utilization
rate;
(ii) "A" is the total revenue
paid to the hospital to determine patient services under the Medicaid state
plan regardless of whether the services were furnished on a fee-for-service
basis or through a managed care program in the hospital's fiscal
year;
(iii) "B" is the cash
subsidies received directly from state and local governments for patient
services in the hospital's fiscal year;
(iv) "C" is the total revenues of the
hospital for patient services, including the amount of such cash subsidies in
the hospital's fiscal year;
(v) "D"
is the total hospital charges for inpatient hospital services attributable to
charity care in the hospital's fiscal year, less any amount received for
payment of these charges attributable to inpatient services. This amount shall
not include contractual allowances and discounts (other than for indigent
patients not eligible for public assistance); and
(vi) "E" is the hospital's total charges for
inpatient hospital services in the hospital's fiscal year.
(b) The above amounts used in the formula
must be from the hospital's most recent fiscal year for which initial cost
reports are available for all hospital providers.
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;
Disclaimer: These regulations may not be the most recent version. Montana 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.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.