Human services

Medical Assistance

SECTION 40-8-20.1

§ 40-8-20.1 Prospective rate increments.

The department may consider the granting of a prospective rate that reflects demonstrated cost increases in excess of the rate that has been established by the application of the percentage increase. In order to qualify for the rate increment, demonstrated increased costs must be the result of:

(a) Demonstrated errors made during the rate determination process;

(b) Significant increases in operating costs resulting from the implementation of new or additional programs, services or staff specifically mandated by the Rhode Island department of health;

(c) Significant increases in operating costs resulting from capital renovations, expansion, or replacement required for compliance with fire safety codes and/or certification requirements of the Rhode Island department of health, as well as increased energy costs which the facility can demonstrate are a result of the facility having expended funds for heating, lighting, hot water, and similar costs associated with the consumption of energy provided by public utilities;

(d) Significant increases in workers' compensation and/or health insurance premiums which cannot be accommodated within the nursing facility's assigned aggregate per diem rate, if cost justified; provided, that assigned per diem rate in the labor and payroll related expenses cost center does not exceed two percent (2%) of the cost center ceiling; or

(e) Extraordinary circumstances, including, but not limited to, acts of God, and inordinate increases in energy costs (e.g. federal BTU tax, regional or national energy crisis). Inordinate increases in energy costs will be immediately reflected in increased rates above the energy cost center ceiling maximum. Provided, however, that such increases will be rescinded immediately upon cessation of the extraordinary circumstance. All requests for rate increments shall be limited to one request per nursing facility for the factors set forth in subsections (b) and (c); provided, additional requests involving a per diem increase in excess of one percent of the nursing facility's previously assigned aggregate per diem rate shall also be reviewed. Before a nursing facility shall be permitted to file for a rate increment, increases in operating costs set forth in subsections (b) and (c) must have been incurred for a period of not less than three (3) months in order to establish proof of the increase. Rate adjustments granted as a result of a request filed within one hundred twenty (120) days after the costs were first incurred shall be made effective retroactively to the date the costs were actually incurred; provided, further, any adjustments granted as a result of requests filed more than one hundred twenty (120) days after the costs were first incurred will be effective on the first day of the month following the filing of the request.

History of Section.
(P.L. 2006, ch. 246, art. 15, § 2; P.L. 2007, ch. 73, art. 12, § 1.)