☰ Revisor of Missouri

Title XII PUBLIC HEALTH AND WELFARE

Chapter 208

Effective - 28 Aug 2014, 2 histories, see footnote (history) bottom

  208.471.  Medicaid reimbursement payments to hospitals — FRA assessments — enhanced graduate medical education payments — alternative reimbursement payments to hospital for Medicaid provider agreements or reimbursement for outpatient services, certain limits not to apply to outpatient services. — 1.  The department of social services shall make payments to those hospitals which have a Medicaid provider agreement with the department.  Prior to June 30, 2002, the payment shall be in an annual, aggregate statewide amount which is at least the same as that paid in fiscal year 1991-1992 pursuant to rules in effect on August 30, 1991, under the federally approved state plan amendments.

  2.  Beginning July 1, 2002, sections 208.453 to 208.480 shall expire one hundred eighty days after the end of any state fiscal year in which the aggregate federal reimbursement allowance (FRA) assessment on hospitals is more than eighty-five percent of the sum of aggregate direct Medicaid payments, uninsured add-on payments and enhanced graduate medical education payments, unless during such one hundred eighty-day period, such payments or assessments are adjusted prospectively by the director of the department of social services to comply with the eighty-five percent test imposed by this subsection.  Enhanced graduate medical education payments shall not be included in the calculation required by this subsection if the general assembly appropriates the state's share of such payments from a source other than the federal reimbursement allowance.  For purposes of this section, direct Medicaid payments, uninsured add-on payments and enhanced graduate medical education payments shall:

  (1)  Include direct Medicaid payments, uninsured add-on payments and enhanced graduate medical education payments as defined in state regulations as of July 1, 2000;

  (2)  Include payments that substantially replace or supplant the payments described in subdivision (1) of this subsection;

  (3)  Include new payments that supplement the payments described in subdivision (1) of this subsection; and

  (4)  Exclude payments and assessments of acute care hospitals with an unsponsored care ratio of at least sixty-five percent that are licensed to operate less than fifty inpatient beds in which the state's share of such payments are made by certification.

  3.  The MO HealthNet division may provide an alternative reimbursement for outpatient services.  Other provisions of law to the contrary notwithstanding, the payment limits imposed by subdivision (2) of subsection 1 of section 208.152 shall not apply to such alternative reimbursement for outpatient services.  Such alternative reimbursement may include enhanced payments or grants to hospital-sponsored clinics serving low income uninsured patients.

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(L. 1992 H.B. 1744 § 208.450, A.L. 2001 H.B. 955, A.L. 2014 H.B. 1299 Revision)

Expires 9-30-18


---- end of effective   28 Aug 2014 ----

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