Current through Register Vol. XLI, No. 50, December 13, 2024
Section 65-26-2 - Definitions2.1. Act - The West Virginia Health Care Authority Act, W. Va. Code § 16-29B-1 et seq.2.2. Affected party - Any interested party which is recognized by the Authority as an affected party.2.3. Authority - Health Care Authority.2.4. CMI - Case Mix Index which is an index determined by multiplying the respective DRG weights in effect at the time of the discharges by the number of discharges for each DRG weight classification in order to arrive at a weighted DRG for each DRG classification. The DRG classifications are then added together and divided by the total number of discharges for the hospital to arrive at a case mix index for the respective category of payors, all as determined by the Authority based upon information submitted by the hospital and other sources of information.2.5. DRG - Diagnosis related group which is a relative measure of resources used to treat inpatients.2.6. DRI - Inflation factor entitled the "New CMS Hospital Prospective Reimbursement Market Basket" published in Global Insight's DRI/WEFA Health Care Cost Review.2.7. IME factor - Indirect medical education factor as developed by the Authority.2.8. Interested party - Any individual, group or organization which files a written request with the Authority on or before the prehearing conference date stating that the individual, group or organization is aggrieved or is likely to be aggrieved based upon information and belief by any act or failure to act by the Authority or by any rule or final order of the Authority and setting forth with particularity the basis for the request.2.9. Weighted Average Case Mix Index - In computing the average CMI for peer grouping purposes, the DRG case weight for discharges is included at twice the value over the prior year. The Authority will use the most recent four (4) years for which it has complete data when calculating the weighted average case mix index.