10A N.C. Admin. Code 22Q.0104

Current through Register Vol. 39, No. 7, October 1, 2024

Section 22Q .0104 - CERTIFYING HOSPITAL DISTRIBUTION

The Department shall distribute available funds to certifying hospitals in two parts:

(1) An amount equal to 10 percent of expenditures certified by the hospital pursuant to 42 CFR 433.51; and

(2) An amount equal to the hospital's proportionate share, calculated pursuant to Rule .0106 of this Section, of the available funds based on the hospital's share of outpatient costs for uninsured patients as a percentage of the Statewide aggregate of outpatient costs for uninsured patients. To be eligible for a proportionate share, a hospital shall file with the Department 90 days prior to the date of payment as determined by the Department, a form prescribed by the Department attesting to the hospital's:

(a) Qualification for disproportionate share status under the "Disproportionate Share Hospital (DSH) Payment" section of the North Carolina Medicaid State Plan, Attachment 4.19-A;

(b) Unreimbursed charges and payments for outpatient services provided to uninsured patients; and

(c) Aggregate Medicaid outpatient cost-to-charge ratio.

10A N.C. Admin. Code 22Q .0104

Authority G.S. 108A-54; 143C-9-9;
Temporary Adoption Eff. December 29, 2021;
Eff. August 1, 2022.

Amended by North Carolina Register Volume 37, Issue 05, September 1, 2022 effective 8/1/2022.