Statutes, codes, and regulations
Wyoming Administrative Code
Agency 048 - Health, Department ofSubagency 0037 - Medicaid
Chapter 30 - LEVEL OF CARE INPATIENT HOSPITAL REIMBURSEMENT
Section 30-15 - Reimbursement for transfers

048-30 Wyo. Code R. § 30-15

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Current through April 27, 2019
Section 30-15 - Reimbursement for transfers

(a) Transferring hospital. A hospital which transfers a patient after admission to another hospital shall receive a per diem payment, not to exceed the level of care payment, except as provided in subsection (d).

(b) Discharging hospital. The hospital which discharges a patient that has been transferred in shall receive a per diem payment, not to exceed the level of care payment, except as provided in subsection (d), unless the admission is a less than one day stay. Less than one day stays shall be reimbursed pursuant to Section 17.

(c) Receiving hospital that does not discharge. A hospital which receives a transfer, and then transfers the patient to another hospital, shall receive a per diem payment, not to exceed the level of care payment, except as provided in subsection (d).

(d) Outlier payments. A hospital receiving reimbursement pursuant to this Section shall be eligible for an outlier payment pursuant to Section 16.

(e) The per diem rate to be paid pursuant to this Section shall be determined as follows:

  • (i) For hospital-specific levels of care. By dividing the applicable level of care payment rate by the providers geometric mean length of stay for that level of care, except that for providers with five or fewer claims in the base period, the statewide geometric mean length of stay was used.
  • (ii) For levels of care capped by the statewide ceiling. By dividing the applicable level of care payment rate by the statewide geometric mean length of stay for that level of care.

(f) Capital payments. Payments made pursuant to this Section shall not include a capital payment unless the facility is entitled to a level of care payment.

048-30 Wyo. Code R. § 30-15