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016.06.20-250.300. Disproportionate Share Payment Eligibility.

AR ADC 016.06.20-250.300Arkansas 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 016.06.20-250.300
016.06.20-250.300. Disproportionate Share Payment Eligibility.
Currentness
A. Hospitals that serve, proportionate to their total inpatient population, a large number of uninsured, low-income, indigent or Medicaid-eligible individuals may be eligible to qualify for supplemental payments known as “disproportionate share hospital (DSH) payments,” from an annual federal allotment designated for that purpose.
B. Acute care, inpatient psychiatric and rehabilitative hospitals may also qualify for DSH payments distributed by the state from the same federal allotment.
1. Only in-state hospital cost report inpatient statistics are used to determine the Medicaid inpatient utilization rates employed in the calculation of the qualifying criteria.
2. Bordering city acute care hospitals that Arkansas Medicaid has paid for more than 850 inpatient days (with dates of service within the qualifying cost report period) are eligible for disproportionate share payments distributed by Arkansas Medicaid. However, inpatient statistics from those hospitals are disregarded when determining Medicaid inpatient utilization rates for disproportionate share payment purposes.
C. The Department of Human Services or its designee determines eligibility for disproportionate share payments. Providers desiring consideration for DSH payment must submit a completed form DMS-628 with their cost report. View or print form DMS-628. Providers not submitting form DMS-628 by the state fiscal year end that coincides with or follows the provider's fiscal year end will not qualify for a disproportionate share payment in that cycle.
D. Cost report data from cost reporting periods ending within a given state fiscal year (July 1 through June 30) are used to calculate disproportionate share payments.
1. The calculations are performed during the state fiscal year following the one from which the cost report data derive.
2. The payments thus calculated are made by the end of the state fiscal year in which they are calculated.
EXAMPLE
a. Hospital D's first fiscal year and its first full 12-month cost reporting period run from April 1, 2002, through March 31, 2003.
b. Hospital D's fiscal year 2003 cost report must be submitted to the Division of Medical Services by August 31, 2003 (five-month deadline).
1.) Disproportionate share payments based on data from cost reporting periods ending between July 1, 2002, and June 30, 2003 (i.e., within state fiscal year 2003), comprise one cycle of disproportionate share payments.
2.) Between July 1, 2003, and June 30, 2004, Medicaid calculates the disproportionate share payments due for the cycle that ended June 30, 2003.
c. Hospital D and all other hospitals qualifying for a disproportionate share payment in the state fiscal year 2003 cycle will receive their payments before July 1, 2004.
d. The following table illustrates the disproportionate share payment timetable for all eligible hospitals.
Cost Reporting Periods Ending in state fiscal year:
2003 (7-1-02 through 6-30-03)
Data Compiled and Payments Calculated during state fiscal year:
2004 (7-1-03 through 6-30-04)
State Must Make Payment No Later Than:
6-30-04
E. The State uses the information submitted on the form DMS-628 and the most recent cost report data available (audited or un-audited) to calculate disproportionate share payments.
F. A hospital must meet each of five criteria to receive a disproportionate share payment. These are discussed in Sections 250.310 through 250.350. The first four of these criteria must be met during the qualifying fiscal year. One criterion must be met in the payment year.

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 016.06.20-250.300, AR ADC 016.06.20-250.300
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