2011 Utah Code
Title 26 Utah Health Code
Chapter 36a Hospital Provider Assessment Act
Section 103 Definitions.

26-36a-103. Definitions.
As used in this chapter:
(1) "Assessment" means the Medicaid hospital provider assessment established by this chapter.
(2) "Discharges" means the number of total hospital discharges reported on worksheet S-3, column 15, lines 12, 14, and 14.01 of the Medicare Cost Report for the applicable assessment year.
(3) "Division" means the Division of Health Care Financing of the department.
(4) "Hospital":
(a) means a privately owned:
(i) general acute hospital operating in the state as defined in Section 26-21-2; and
(ii) specialty hospital operating in the state, which shall include a privately owned hospital whose inpatient admissions are predominantly:
(A) rehabilitation;
(B) psychiatric;
(C) chemical dependency; or
(D) long-term acute care services; and
(b) does not include:
(i) a residential care or treatment facility as defined in Section 62A-2-101;
(ii) a hospital owned by the federal government, including the Veterans Administration Hospital;
(iii) a Shriners hospital that does not charge for its services; or
(iv) a hospital that is owned by the state government, a state agency, or a political subdivision of the state, including:
(A) a state-owned teaching hospital; and
(B) the Utah State Hospital.
(5) "Low volume select access hospital" means a hospital that furnished inpatient hospital services during fiscal year 2008 to less than 300 Medicaid cases under the select access program.
(6) "Medicare cost report" means CMS-2552-96, the cost report for electronic filing of hospitals.
(7) "Select access cases" means the number of hospital inpatient cases related to individuals enrolled in the state's select access program for 2008.
(8) "State plan amendment" means a change or update to the state Medicaid plan.
(9) "Upper payment limit" means the maximum ceiling imposed by federal regulation on a hospital Medicaid reimbursement for inpatient services under 42 C.F.R. Sec. 447.272.
(10) "Upper payment limit gap":
(a) means the difference between:
(i) the inpatient hospital upper payment limit for hospitals; and
(ii) Medicaid payments for inpatient hospital services not financed using hospital assessments paid by all hospitals;
(b) shall be calculated separately for hospital inpatient services; and
(c) does not include Medicaid disproportionate share payments as part of the calculation for the upper payment limit gap.