Section 86-4.11 - Computation of basic rate for facilities other than licensed free-standing ambulatory surgery centers

86-4.11 Computation of basic rate for facilities other than licensed free-standing ambulatory surgery centers.

(a) Rates of payment for facilities other than licensed free-standing ambulatory surgery centers shall be established on a prospective basis and shall be computed on the basis of allowable fiscal and statistical data submitted by the facility for the fiscal year ended at least 15 months prior to the year for which rates are being set. Unless otherwise specified in this Subpart, the computed rates shall be all-inclusive, taking into consideration total allowable costs and total billable patient visits or procedures.

(b) Rates will be determined by applying ceiling limitations to allowable operating costs, applying the trend factor to the result, adding reimbursable capital costs, and dividing the sum by the total number of visits or procedures. In the case of proprietary facilities, a return on investment shall be added to reimbursable costs.

(c) Certification by the commissioner of reimbursement rates of payment by governmental agencies for the period April 1, 1993 through March 31, 1994 shall be extended six months, through September 30, 1994, by applying the applicable trend factors. Rates of payment shall then be for the fiscal-year period October 1st through September 30th. Approval by the commissioner of reimbursement rates for article 43 corporations shall be for the periods specified in the reimbursement formula approved by the Commissioner of Health.
 

Effective Date: 
Wednesday, July 13, 1994
Doc Status: 
Complete