37.86.2935    CALCULATING LOW INCOME UTILIZATION RATE, FOR ROUTINE DISPROPORTIONATE SHARE HOSPITALS

(1) The low income utilization rate is used to determine whether a hospital is deemed a routine disproportionate share hospital. The percentage rate is computed as follows:

(a) LIUR=((A + B)/C) + (D/E) where:

(i) "LIUR" is the low income utilization rate;

(ii) "A" is the total revenue paid to the hospital to determine patient services under the Medicaid state plan regardless of whether the services were furnished on a fee-for-service basis or through a managed care program in the hospital's fiscal year;

(iii) "B" is the cash subsidies received directly from state and local governments for patient services in the hospital's fiscal year;

(iv) "C" is the total revenues of the hospital for patient services, including the amount of such cash subsidies in the hospital's fiscal year;

(v) "D" is the total hospital charges for inpatient hospital services attributable to charity care in the hospital's fiscal year, less any amount received for payment of these charges attributable to inpatient services. This amount shall not include contractual allowances and discounts (other than for indigent patients not eligible for public assistance); and

(vi) "E" is the hospital's total charges for inpatient hospital services in the hospital's fiscal year.

(b) The above amounts used in the formula must be from the hospital's most recent fiscal year for which initial cost reports are available for all hospital providers.

History: 2-4-201, 53-2-201, 53-6-113, MCA; IMP, 2-4-201, 53-2-201, 53-6-101, 53-6-111, 53-6-113, 53-6-149, MCA; NEW, 2004 MAR p. 482, Eff. 2/27/04.