Secs. 19a-164 to 19a-165v. Task force to study the development of a prospective payment system and other health issues. Professional advisory committee. Definitions. Data necessary for the development
Secs. 19a-164 to 19a-165v. Task force to study the development of a prospective payment system and other health issues. Professional advisory committee. Definitions. Data necessary for the development and implementation of the prospective
payment system; submission. Determination of rate orders; contents. Rate orders
for the rate year commencing in 1987 and for subsequent rate years; establishing
a standard fixed charge per case; inpatients; interim and final compliance; special
arrangements. Gross inpatient service revenue for the fiscal year commencing in
1986 and for subsequent fiscal years. Estimates on volume and revenue, submission; adjustments. Establishing per diem charges for exempt cases; adjustments;
outliers; billing form; reimbursement by Department of Income Maintenance. Discounts for medical assistance and Medicare payers. Uncompensated care. Gross
outpatient service revenue; short hospital stays; transfer system. Alternative delivery systems. Review of hospital admissions; appeals of appropriateness of the diagnostic related group assigned to a discharge; fee. Federal waivers for Medicare
and medical assistance payer participation. Adjustment of allowable revenues for
the fiscal years commencing in 1985 and 1986. Application alleging financial integrity in jeopardy; hearing, determination, remedy; projects requiring approval by
commission; adjustments. Hospitals not previously subject to the prospective payment system; new hospitals. Experiments and demonstration projects. Regulations
for the prospective payment system. Issuance of rate orders for the fiscal year
commencing in 1987. Conformance with rate order; decision; reconsideration;
hearing. Prospective payment system account. Self-pay patients; appeals. Emergency regulations. Sections 19a-164 to 19a-165v, inclusive, are repealed.
(P.A. 84-315, S. 1-20, 24; P.A. 86-86; 86-91, S. 1-4; P.A. 87-122, S. 1, 2; 87-443, S. 1-17; 87-510, S. 2-6; P.A. 88-8, S. 1; 88-357, S. 3, 4, 22; P.A. 89-371, S. 30, 31.)