TITLE 40
Human services

CHAPTER 40-8.3
Uncompensated Care

SECTION 40-8.3-9


§ 40-8.3-9 Outpatient adjustment payments for fiscal year 2012.

Effective July 1, 2011, the executive office of health and human services is hereby authorized and directed to amend its regulations for reimbursement to hospitals for outpatient services 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 a quarterly adjustment payment during state fiscal year 2012 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 each hospital's fiscal year ending during 2010;

(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 2010.

(3) Multiply the sum of all Medicaid payments as determined in (2) by 72.57 percent and then multiply that result by each hospital's percentage of the state's total Medicaid outpatient and emergency department services as determined in (1) to obtain the total outpatient adjustment for each hospital to be paid in SFY 2012;

(4) Pay each hospital on or before July 20, 2011, October 20, 2011, January 20, 2012, and April 20, 2012 one-quarter of its total outpatient adjustment as determined in (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.

History of Section.
(P.L. 2011, ch. 151, art. 18, § 2.)