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Title: Section 86-1.38 - Transition pool for 2010-2013 period

Effective Date


86-1.38 Transition pool for 2010-2013 period.

(a) Subject to the availability of federal financial participation, the commissioner may, for rate periods effective on and after October 20, 2010, increase inpatient Medicaid fee-for-service rates subject to this Subpart for the following periods and in the following amounts:

(1) for the period October 20, 2010 through March 31, 2011, up to thirty-seven million five hundred thousand dollars;

(2) for the period April 1, 2011 through March 31, 2012, up to seventy-five million dollars;

(3) for the period April 1, 2012 through March 31, 2013, up to fifty million dollars;

(4) for the period April 1, 2013 through March 31, 2014, up to twenty-five million dollars.

(b) The distributions authorized pursuant to this section shall be made available through a reduction, as determined by the commissioner, in the state-wide base price as otherwise computed in accordance with this Subpart.

(c) Hospitals eligible for distributions pursuant to this section shall be public and non-public general hospitals with Medicaid inpatient discharges equal to or greater than seventeen and one-half percent as reported for the 2007 period.

(d) Funds allocated pursuant to this section shall be allocated to eligible hospitals pursuant to a formula, as determined by the commissioner, such that, to the extent of funds available, no hospital’s reduction in total Medicaid fee-for-service inpatient revenue for the corresponding rate periods, as a result of the application of otherwise applicable rate-setting methodologies in effect for such periods, exceeds a percentage reduction as determined by the commissioner.

(e) Hospitals receiving funds pursuant to this section that did not previously receive funds to facilitate improvements in hospital operations and finances beginning on December 1, 2009, shall, as a condition for eligibility for such funds, adopt a resolution of the Board of Directors of each such hospital setting forth its current financial condition, including ongoing board oversight, and shall, after two years, issue a report as adopted by each such Board of Directors setting forth what progress has been achieved regarding such improvement, provided, however, if such report fails to set forth adequate progress, as determined by the Commissioner, the Commissioner will deem such facility ineligible for further distributions pursuant to this section and will redistribute such further distributions to other eligible facilities in accordance with the provisions of this section. The Commissioner shall be provided with copies of all such resolutions and reports.


VOLUME A-2 (Title 10)