37.86.2940    HOSPITAL REIMBURSEMENT ADJUSTOR (HRA), DATA SOURCES

(1) An inpatient hospital reimbursement adjustor (HRA) payment will be made to a Montana PPS hospital or critical access hospital, as those terms are defined in 50-5-101, MCA, that provides inpatient hospital services.

(2) Data sources for the department to determine which hospitals meet the criteria to receive HRA payments, and the amount of the payments, may include, but are not limited to:

(a) the Montana Hospital Association (MHA) database;

(b) the Medicaid paid claims database;

(c) filed or settled cost reports; and

(d) reports from the Licensure Bureau of the Quality Assurance Division.

(3) Eligibility evaluations, payment amount calculations, and payments will be made annually.

(4) The Montana State Hospital or a hospital or a facility operated by the state, a political subdivision of the state, the United States, or an Indian Tribe or any facility authorized under the Indian Health Care Improvement Act are not eligible for HRA.

 

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; AMD, 2019 MAR p. 2382, Eff. 1/1/20.