D.C. Mun. Regs. tit. 29, r. 29-970
For services rendered on or after October 1, 2007 each ICF/MR shall be paid its base year per diem rate calculated in accordance with Sections 968 and 969 and adjusted for inflation pursuant to this section.
Beginning October 1, 2007 through September 30, 2008, the base year per diem rate paid in the District's Fiscal Year 2002 shall be indexed for inflation from the District's Fiscal Year 2002 through the District's Fiscal Year 2008 using the Centers for Medicare and Medicaid Services Prospective Payment Skilled Nursing Facility Input Price Index ("CMS Index"). On October 1st of each successive year after Fiscal Year 2008, the base year per diem rate shall be indexed for inflation using the CMS index.
[Repealed at 55 DCR 5275]
[Repealed at 55 DCR 5275]
In order to meet the Medicare upper limits requirement, the rate paid to each facility shall not exceed the amount that Medicare would pay for the same service. When necessary, each facility-specific prospective rate will be reduced to maintain compliance with the upper limit set by Medicare. The reduction factor shall be the same for each facility without regard to Medicaid utilization.
The Medicaid Program may approve an adjustment to the facility specific per diem rate if the facility demonstrates that it incurred higher costs due to extraordinary circumstances beyond its control including, but not limited to strikes, fire, earthquake, flood, changes in federal or District law or rules regarding new services, wages, hours, or employee benefits or similar unusual occurrences with substantial effects.
Each adjustment shall be made only to the extent the costs are reasonable, attributable to the circumstances specified, separately identified by the facility, and verified by the program.
Effective December 30, 2000, in addition to the facility specific per diem rate calculated in accordance with Subsection 970.1, the Medicaid Program shall pay an additional amount to an ICF/MR for each resident receiving active treatment services pursuant to the requirements set forth in Subsections 970.9 through 970.11.
Active treatment services shall be provided in accordance with each resident's individualized habilitation plan.
Each ICF/MR shall enter into a written agreement with each provider of active treatment services which meets the requirements set forth in 42 C.F.R. § 483.410(d).
The additional amount paid to an ICF/MR for each resident receiving active treatment services shall be calculated by multiplying the per diem rate on the day preceding the effective date of these rules for each resident receiving active treatment services, times the number of days the resident receives active treatment services.
D.C. Mun. Regs. tit. 29, r. 29-970