Ala. Admin. Code r. 560-X-23-.11
Current through Register Vol. 43, No. 1, October 31, 2024
Section 560-X-23-.11 - Other Matters(1) The total Medicaid cost per diems can be adjusted if the hospital experiences extraordinary circumstances which may include, but are not limited to, an Act of God, war, or civil disturbance. Adjustments to reimbursement rates may be made in these and related circumstances at the discretion of the Alabama Medicaid Commissioner.(2) New Hospital Facilities - A new facility shall submit a budget of cost for Medicaid inpatient services for its initial cost reporting period. The Alabama Medicaid Agency will determine a per diem rate from this budget. After the budget period, an actual cost report will be filed for the budgeted period. The Alabama Medicaid Agency will calculate a per diem rate in order to determine if any under or overpayment has been made to the hospital.(3) In a transfer which constitutes a change of ownership, the old and new providers shall reach an agreement between themselves concerning trade accounts payable, accounts receivable, and bank deposits. Medicaid will pay the new provider for unpaid claims for services rendered both prior to and after the change of ownership. The new provider shall be liable to Medicaid for unpaid amounts due Medicaid from the old provider.Ala. Admin. Code r. 560-X-23-.11
Emergency rule effective June 9, 1986. Permanent rule effective June 9, 1986. Amended: effective September 8, 1986; June 10, 1987. Repealed and New Rule: Filed November 10, 2010; effective December 15, 2010.Amended by Alabama Administrative Monthly Volume XXXIII, Issue No. 11, August 31, 2015, eff. 9/15/2015.(See history note at end of chapter.) Previous Rule .11, Cost to Related Organizations was repealed and Rule .20 was renumbered to .11 as per certification filed November 10, 2010; effective December 15, 2010.
Author: Keith Boswell, Director, Provider Audit/Reimbursement
Statutory Authority: State Plan; Title XIX, Social Security Act; 42 C.F.R. §§ 401, et seq.