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 37.86.2940 - INPATIENT HOSPITAL REIMBURSEMENT ADJUSTOR (HRA), DATA SOURCES

Universal Citation: MT Admin Rules 37.86.2940

Current through Register Vol. 18, September 20, 2024

(1) An inpatient hospital reimbursement adjustor (HRA) payment will be made to a Montana PPS hospital or critical access hospital, as those terms are defined in 50-5-101, MCA, that provides inpatient hospital services.

(2) Data sources for the department to determine which hospitals meet the criteria to receive HRA payments, and the amount of the payments, may include, but are not limited to:

(a) the Montana Hospital Association (MHA) database;

(b) the Medicaid paid claims database;

(c) filed or settled cost reports; and

(d) reports from the Licensure Bureau of the Quality Assurance Division.

(3) Eligibility evaluations, payment amount calculations, and payments will be made annually.

(4) The Montana State Hospital or a hospital or a facility operated by the state, a political subdivision of the state, the United States, or an Indian Tribe or any facility authorized under the Indian Health Care Improvement Act are not eligible for HRA.

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

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.
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