2011 California Code
Welfare and Institutions Code
DIVISION 9. PUBLIC SOCIAL SERVICES [10000 - 18996]
ARTICLE 5.21. Medi-Cal Hospital Provider Rate Stabilization Act
Section 14167.2

(a) Private hospitals shall be paid supplemental amounts for the provision of hospital outpatient services as set forth in this section. The supplemental amounts shall be in addition to any other amounts payable to hospitals with respect to those services and shall not affect any other payments to hospitals.

(b) Except as set forth in subdivisions (e) and (f), each private hospital shall be paid an amount for each subject fiscal year equal to a percentage of the hospital s outpatient base amount. The percentage shall be the same for each hospital for a subject fiscal year and shall result in payments to hospitals that equal the applicable federal upper payment limit.

(c) In the event federal financial participation for a subject fiscal year is not available for all of the supplemental amounts payable to private hospitals under subdivision (b) due to the application of a federal upper limit or for any other reason, both of the following shall apply:

(1) The total amount payable to private hospitals under subdivision (b) for the subject fiscal year shall be reduced to the amount for which federal financial participation is available.

(2) The amount payable under subdivision (b) to each private hospital for the subject fiscal year shall be equal to the amount computed under subdivision (b) multiplied by the ratio of the total amount for which federal financial participation is available to the total amount computed under subdivision (b).

(d) The supplemental amounts set forth in this section are inclusive of federal financial participation.

(e) No payments shall be made under this section to a new hospital.

(f) No payments shall be made under this section to a converted hospital for the portion of the subject fiscal year that begins on October 1 and ends on June 30 for the subject fiscal year that includes the first day of the subject federal fiscal year in which the hospital becomes a converted hospital, and for all subsequent subject fiscal years. In the event of a conflict between the provisions of this subdivision and the terms of a state plan amendment required for the receipt of approval by the federal Centers for Medicare and Medicaid Services, the state plan amendment shall control.

(g) In the event that the amounts payable as calculated under subdivision (b) for the 2008 09 subject fiscal year are reduced by the operation of subdivision (c) and the ratio for the 2008 09 subject fiscal year described in paragraph (2) of subdivision (c) is less than 0.25, the difference between 25 percent of the amounts payable as calculated under subdivision (b) and the amounts payable after the application of subdivision (c) shall be added to the supplemental payments for each private hospital calculated under subdivision (b) for the 2009 10 subject fiscal year.

(h) In the event that the amounts payable as calculated under subdivision (b) for the 2009 10 subject fiscal year, including any carryover amounts determined under subdivision (g), are reduced by the operation of subdivision (c), the difference between the amounts payable as calculated under subdivision (b), including any carryover amounts, and the amounts payable after the application of subdivision (c) shall be added to the supplemental payments for each private hospital calculated under subdivision (b) for the 2010 11 subject fiscal year.

(Amended by Stats. 2010, Ch. 714, Sec. 6. Effective October 19, 2010. Conditionally inoperative as provided in Sections 14167.14 (subd. (c)) and 14167.39 (subd. (a)). Conditionally repealed on December 1, 2010, pursuant to Section 14167.18. Repealed as of January 1, 2013, pursuant to Section 14167.17, if not repealed earlier.)