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016.06.20-250.320. A Qualifying Utilization Rate.

AR ADC 016.06.20-250.320Arkansas 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 016.06.20-250.320
016.06.20-250.320. A Qualifying Utilization Rate.
Currentness
A. To qualify for disproportionate share payments, a hospital's Medicaid inpatient utilization rate or its low-income utilization rate must be at a certain level.
1. The Medicaid inpatient utilization rate is a relative indicator because it must be at a certain level relative to the mean utilization level for the state.
2. The low-income utilization rate is not considered relative to other hospitals; an individual hospital's low-income utilization rate (see Section 250.301, part G) must exceed 25% of its total utilization.
B. Either indicator can qualify a hospital for disproportionate share payments.
1. Each indicator is linked to a formula for calculating the payment amount.
2. If a hospital qualifies by both indicators, the state calculates the payment amounts by both formulas and awards the higher payment to the hospital.

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 016.06.20-250.320, AR ADC 016.06.20-250.320
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