D.C. Mun. Regs. tit. 29, r. 29-974

Current through Register Vol. 71, No. 49, December 6, 2024
Rule 29-974 - REIMBURSEMENT FOR NEW PROVIDERS
974.1

New providers shall submit a pro forma cost report based on a budget of estimated first year costs. The program has the right to review and adjust each facility's proforma cost report.

974.2

New providers shall be paid an interim rate which is based on the sum of the lesser of the base year median rates or budgeted operating costs and budgeted capital related costs. Capital related costs shall be subject to a ceiling set by the Medicaid Program based on reasonableness.

974.3

The first year costs for the initial rate period shall be adjusted to September 30, 1993 using a factor obtained from the Bureau of Labor Statistics Medical Care Services Consumer Price Index for Washington D.C. The final rate will be calculated consistent with §§ 969, 970 and 971 of these rules.

974.4

A provider that enters the Medicaid program after October 1, 2007 shall submit a pro forma cost report based on a budget of estimated first year costs. MAA reserves the right to review and adjust each facility's pro forma cost report. The provider shall be paid an interim rate which is based on the lesser of the base year median rates adjusted for inflation pursuant to Section 969 or budgeted operating costs and budgeted capital costs. The interim rate shall remain in effect until the provider's first complete Fiscal Year including 12 months of operational costs has been audited and a final rate is established. Upon completion of the audit of the facility's cost report, the facility shall be notified of the final rate and the facility's payments shall be adjusted accordingly.

D.C. Mun. Regs. tit. 29, r. 29-974

Final Rulemaking published at 45 DCR 2333, 2347 (April 17, 1998); as amended by Final Rulemaking published at 55 DCR 5275 (May 2, 2008)
Authority: 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. 744; D.C. Official Code § 1-307.2)); Reorganization Plan No. 4 of 1996, effective January 13, 1997; and Mayor's Order 97-42, dated February 18, 1997.