TITLE 40
Human services

CHAPTER 40-8.3
Uncompensated Care

SECTION 40-8.3-6


§ 40-8.3-6 Outpatient adjustment payments for fiscal year 2009.

Effective July 1, 2008, the department of human services is hereby authorized and directed to amend its regulations and the Rhode Island State Plan for Medical Assistance pursuant to Title XIX of the Social Security Act for reimbursement to hospitals for outpatient service as follows:

Hospitals – Outpatient adjustment payments.

(a) Each hospital in the state of Rhode Island, as defined in subdivision 23-17-38.1(c)(1), shall receive an adjustment payment during state fiscal year 2009 of an amount determined as follows:

(1) Determine the percent of the state's total Medicaid outpatient and emergency department services (exclusive of physician services) provided by each hospital during the hospital's fiscal year ending during 2007;

(2) Determine the sum of all Medicaid payments to hospitals made for outpatient and emergency department services (exclusive of physician services) provided during each hospital's fiscal year ending during 2007;

(3) Multiply the sum of all Medicaid payments as determined in subdivision (2) by fifty-six and five hundredths percent (56.05%) and then multiply that result by each hospital's percentage of the state's total Medicaid outpatient and emergency department services as determined in subdivision (1) to obtain the total outpatient adjustment for each hospital to be paid in SFY 2009;

(4) Pay each hospital on its total outpatient adjustment as determined in subdivision (3) above.

(b) The amounts determined in subsection (a) are in addition to Medicaid outpatient payments and emergency services payments (exclusive of physician services) paid to hospitals in accordance with current state regulation and the Rhode Island Plan for Medicaid assistance pursuant to Title XIX of the Social Security Act and are not subject to recoupment or settlement.

(c) The payments are expressly conditioned upon approval by the secretary of the United States Department of Health and Human Services, or his or her authorized representative, of any Medicaid state plan amendment necessary to secure for the state the benefit of federal financial participation in federal fiscal year 2009 for such payments, such amendment to be filed not later than July 9, 2008.

History of Section.
(P.L. 2009, ch. 68, art. 19, § 2.)