§ 40-8.3-7 - Outpatient adjustment payments for fiscal year 2010.
SECTION 40-8.3-7
§ 40-8.3-7 Outpatient adjustment paymentsfor fiscal year 2010. – Effective July 1, 2009, the department of human services is hereby authorizedand directed to amend its regulations and the Rhode Island State Plan forMedical Assistance pursuant to Title XIX of the Social Security Act forreimbursement to hospitals for outpatient services as follows:
(a) Each hospital in the state of Rhode Island, as defined insubdivision 23-17-38.1(b)(1), shall receive a quarterly adjustment paymentduring state fiscal year 2010 of an amount determined as follows:
(1) Determine the percent of the state's total Medicaidoutpatient and emergency department services (exclusive of physician services)provided by each hospital during the hospital's fiscal year ending during 2008;
(2) Determine the sum of all Medicaid payments to hospitalsmade for outpatient and emergency department services (exclusive of physicianservices) provided during each hospital's fiscal year ending during 2008;
(3) Multiply the sum of all Medicaid payments as determinedin subdivision (2) by seventy-seven and forty-one hundredths percent (77.41%)and then multiply that result by each hospital's percentage of the state'stotal Medicaid outpatient and emergency department services as determined insubdivision (1) to obtain the total outpatient adjustment for each hospital tobe paid in SFY 2010;
(4) Pay each hospital on or about July 20, 2009, October 20,2009, January 20, 2010, and April 20, 2010 one-quarter (.25) of its totaloutpatient adjustment as determined in subdivision (3) above.
(b) The amounts determined in subsection (a) are in additionto Medicaid outpatient payments and emergency services payments (exclusive ofphysician services) paid to hospitals in accordance with current stateregulation and the Rhode Island Plan for Medicaid Assistance pursuant to TitleXIX of the Social Security Act and are not subject to recoupment or settlement.