2014 Kentucky Revised Statutes CHAPTER 205 - PUBLIC ASSISTANCE AND MEDICAL ASSISTANCE 205.637 Enhanced Medicaid payments to county-owned or operated hospitals -- Payments to other hospitals.
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205.637 Enhanced Medicaid payments to county-owned or operated hospitals
-- Payments to other hospitals.
(1)
(a)
(b)
(c)
(d)
(e)
A county-owned or operated hospital shall receive an enhanced Medicaid
payment in an amount, calculated from the most recent cost report filed
by that hospital with the department as of June 30 of each year, equal to
the difference between the amount of total payments made to the hospital
by the department or a managed care entity for covered services provided
to Medicaid beneficiaries, including services attributable to recipients in
Medicaid managed care programs, during the state fiscal year and the
hospital's cost for the services determined by the department under
Medicare payment principles. Reimbursement under this section shall be
made in a single payment. From July 1 through August 1 of each year,
the Department for Medicaid Services shall calculate the payment due to
be made to each county-owned or operated hospital and shall make the
payment to each hospital no later than August 15 of each state fiscal
year. The department shall make an enhanced payment to each
county-owned or operated hospital in state fiscal year 1998 using cost
reports filed with the department on or before June 30, 1998, for the
hospitals' latest fiscal year.
A payment described in this section is not due to a county-owned or
operated hospital unless an intergovernmental transfer is made. A
county-owned or operated hospital may make an intergovernmental
transfer, or an intergovernmental transfer may be made on behalf of the
hospital by a county, budget unit of a county governmental agency, or
lending institution if it is not prohibited by state or federal law.
An intergovernmental transfer shall be made to the enhanced Medicaid
payment fund by August 2 of each state fiscal year in an amount equal to
eighty percent (80%) of the amount determined under paragraph (a) of
this subsection and shall be matched with federal funds.
An enhanced Medicaid payment shall be made to each county-owned or
operated hospital participating in the intergovernmental transfer program
in an amount equal to one hundred percent (100%) of the hospital's
Medicaid shortfall as determined under paragraph (a) of this subsection.
The department shall determine the Medicaid shortfall for all other
hospitals that are not county-owned or operated or are not
state-university-owned or operated hospitals, which shall be equal to the
difference between total payments made by the department or a
managed care entity for covered services provided to Medicaid
beneficiaries, including those enrolled in managed care, during the state
fiscal year and the hospital's costs for the services as determined by the
department under Medicare payment principles. Funds remaining from
the enhanced Medicaid program shall be distributed to each hospital
which is not county-owned or operated or is not state-university-owned or
operated on a pro rata basis. If funds remain in the enhanced Medicaid
payment fund after making enhanced Medicaid payments required by this
subsection, the remaining funds shall be available for use by the
department for funding the regular Medicaid program.
(2)
(3)
The enhanced Medicaid payment authorized under subsection (1) of this
section shall not be implemented as part of the disproportionate share hospital
program or if federal financial participation is not available.
The Cabinet for Health and Family Services shall promulgate administrative
regulations to implement the provisions of this section.
Effective:June 20, 2005
History: Amended 2005 Ky. Acts ch. 99, sec. 257, effective June 20, 2005. -Created 1998 Ky. Acts ch. 545, sec. 2, effective July 15, 1998.
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