Statutes, codes, and regulations
District Of Columbia Administrative Code
Title 29 - PUBLIC WELFARE
Chapter 29-48 - MEDICAID REIMBURSEMENT FOR INPATIENT HOSPITAL SERVICES
Rule 29-4806 - INPATIENT SERVICES: CALCULATION OF RELATIVE WEIGHTS

D.C. Mun. Regs. tit. 29, r. 29-4806

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Current through Register Vol. 71, No. 43, October 25, 2024
Rule 29-4806 - INPATIENT SERVICES: CALCULATION OF RELATIVE WEIGHTS
4806.1

For Medicaid reimbursement of inpatient hospital discharges occurring on or after October 1, 2014, DHCF shall use hospital-Specific Relative Value (HSRV) version 31 national weights for APR-DRGs. The HSRV method adjusts for differences in cost-to-charge ratios (CCR) among hospitals nationwide.

4806.2

Each DRG assignment shall reflect a severity of illness (SOI) in its associated relative weight. Relative weights are updated biennially at the time the APR-DRG grouper version is updated. The annual APR-DRG documentation from 3MT describes the changes made each year.

D.C. Mun. Regs. tit. 29, r. 29-4806

Final Rulemaking published at 45 DCR 4141, 4147 (June 26, 1998); as amended by Final Rulemaking published at 46 DCR 8271, 8273 (October 15, 1999); as amended by Notice of Emergency and Proposed Rulemaking published at 57 DCR 2691 (March 26, 2010) [EXPIRED]; as amended by Notice of Emergency and Proposed Rulemaking published at 57 DCR 6837 (July 10, 2010) [EXPIRED]; as amended by Notice of Final Rulemaking published at 58 DCR 4323, 4328 (May 20, 2011); as amended by Final Rulemaking published at 59 DCR 15078 (December 28, 2012); amended by Final Rulemaking published at 63 DCR 5234 (4/8/2016)
29 DCMR § 4806 is formerly entitled SCalculation of all Patients Diagnosis-related Groups (APDRG) Relative Weights".
Authority: The Director of the Department of Health Care Finance (DHCF), pursuant to the authority set forth in An Act to enable the District of Columbia to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program and for other purposes, approved December 27, 1967 (81 Stat. 774; D.C. Official Code § 1-307.02 (2001; Supp. 2008)) and section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6) (2001; Supp. 2008)).