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016.06.20-250.202. Mass Adjustments.

AR ADC 016.06.20-250.202Arkansas 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 016.06.20-250.202
016.06.20-250.202. Mass Adjustments.
Currentness
A. If the new interim per diem rate differs from the previous interim rate, the Medicaid fiscal agent performs automated (“mass”) adjustment transactions.
1. The automated adjustments ensure that all inpatient dates of service within the same cost reporting period are paid at the same interim per diem rate.
2. These adjustments apply to claims for inpatient services that have been:
a. Provided since the beginning of the current cost reporting period and
b. Paid before the implementation of the newly calculated per diem rate.
B. Continuing the example above in Section 250.201, Medicaid has scheduled implementation of the hospital's fiscal year 2002 per diem rate for check-write date January 4, 2002.
1. Concurrent with implementation of the new per diem rate, EDS performs mass adjustments for inpatient dates of service on and after July 1, 2001 that have been previously paid at the former rate.
2. Upon completion of the mass adjustments, all of Hospital A's inpatient dates of service in FY 2002 will have been paid at $ 648.00 per Medicaid-covered day.
C. For the purposes of this example let us say that the previous interim per diem rate was $ 646.00--two dollars less than the new rate--and that Medicaid has already paid claims for one hundred inpatient days with dates of service between July 1, 2001, and the dateof the mass adjustments.
1. As a result of the mass adjustments Medicaid pays Hospital A an additional amount of two hundred dollars (two dollars multiplied by 100 Medicaid-paid inpatient days).
2. Arkansas Medicaid's fiscal accounting system reflects that each claim for service dates in fiscal year 2002 that was initially paid at $ 646.00 per day has been voided, reprocessed automatically and repaid at $ 648.00 per day.
3. The provider's Medicaid remittance advice reflects the above information on the scheduled check-write date.

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 016.06.20-250.202, AR ADC 016.06.20-250.202
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