W. Va. Code R. § 65-8-3

Current through Register Vol. XLI, No. 50, December 13, 2024
Section 65-8-3 - Gross Patient Revenue To Be AllowedHospitals During The Control Period
3.1. General. -- During the control period, no hospital shall earn gross patient revenues in excess of that allowed by the provisions of these rules. The amount of allowed gross patient revenue shall be calculated by the hospital and verified by the Authority. This calculation shall be made after the end of the hospital's fiscal year ending in 1984 and after the Authority sets the initial rate schedule for the hospital and shall be reported within one hundred twenty (120) days of the end of that fiscal year in a form and manner prescribed by the Authority. Any gross patient revenue in excess of that allowed by these rules shall be paid to the Authority in a manner prescribed by the Authority. The Authority may take into consideration the impact of the amount payable on the hospital's solvency in establishing a schedule of payment of excess gross patient revenue to the Authority. Payment due the Authority also may be assigned by the Authority to future patients by directing a hospital to reduce rates.
3.2. Allowed rate of increase in gross patient revenue. -- The allowed rate of increase in a hospital's gross patient revenue during the control period shall be twelve percent (12%) per annum, adjusted for changes in the hospital's proportion of Medicare, Medicaid or charity care patients. A set of allowed rates shall be calculated for each hospital consisting of a rate for the first twelve (12) months of the control period and a rate for the remainder of the control period. The rate for the first twelve (12) months shall be based on the information reported in the hospital's audited financial statement for the fiscal year ending in 1983. The rate for the remaining portion of the control period shall be based on the hospital's audited financial statement for the fiscal year ending in 1984.

The formulas for calculating the allowed rates of increase are as found in Table 65-8A found at the end of this regulation.

3.3. Calculation of gross patient revenue allowed in control period.
3.3.1. The amount of gross patient revenue allowed a hospital for the first twelve (12) months of the control period shall be the gross patient revenue reported for the base period times the sum of one (1) plus the allowed rate of increase for the twelve (12) months. (See Table 65-8B at the end of this regulation.)
3.3.2. The amount of gross patient revenue allowed a hospital for the remaining portion of the control period shall be the gross patient revenue allowed for the first twelve (12) months times the sum of one (1) plus the allowed rate of increase for remaining months of the control period times the ratio of the number of months remaining in the control period to twelve (12). (See Table 65-8C at the end of this regulation.)
3.3.3. The total amount of gross patient revenue allowed a hospital during the control period shall be the sum of:
(a) The gross patient revenue allowed for the first twelve (12) months (GPR);
(b) The gross patient revenue allowed for the remaining portion of the control period (GPR); and
(c) Such amount that the Authority may, upon application of a hospital, determine to be necessary as a result of projects undertaken in conformance with Certificate of Need approvals or exemptions issued in accordance with article two-d, chapter sixteen of the Code.

W. Va. Code R. § 65-8-3