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016.06.20-250.100. Introduction to Reimbursement.

AR ADC 016.06.20-250.100Arkansas Administrative Code

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 20. Hospital/Critical Access Hospital (CAH)/End-Stage Renal Disease (ESRD) Provider Manual (Refs & Annos)
Section 250.000. Reimbursement.
Ark. Admin. Code 016.06.20-250.100
016.06.20-250.100. Introduction to Reimbursement.
Currentness
A. All Medicaid-enrolled acute care hospitals in Arkansas and some acute care hospitals in adjacent states are reimbursed for inpatient services by interim per diem and year-end cost settlement. Most hospitals outside Arkansas are reimbursed for inpatient services by means of a prospective payment system.
B. Reimbursement for outpatient hospital services and end-stage renal disease (ESRD) services is by a fee-for-service methodology in accordance with an established fee schedule and without cost settlement, with the following exceptions:
1. Arkansas Medicaid cost-settles for outpatient services with in-state pediatric hospitals.
2. Arkansas Medicaid cost-settles for outpatient services with Arkansas State Operated Teaching Hospitals, effective for cost reporting periods ending on and after June 30, 2000.
3. Effective May 18, 2000, Arkansas State Operated Teaching Hospitals receive an annual outpatient reimbursement adjustment based on the previous state fiscal year's (SFY) outpatient Medicare-related upper payment limit (UPL) for “as identified Medicaid-reimbursed” outpatient services. See Section 252.030.

Credits

Eff. Oct. 13, 2003.
<Editor’s Note: Nonfunctioning links so in original.>
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.20-250.100, AR ADC 016.06.20-250.100
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