Administrative Code

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Virginia Administrative Code
Title 12. Health
Agency 30. Department of Medical Assistance Services
6/3/2020

Chapter 70. Methods and Standards for Establishing Payment Rates - Inpatient Hospital ServicesRead Chapter

Section 10
Effect of participation in Health Insurance for the Aged program
Section 20
Standards applied to non-participants in Title XVIII programs
Section 30
Limitations of Medical Assistance Program payment; Medicare reimbursement principles
Section 40
Payment of reasonable costs based on other methods
Section 50
Hospital reimbursement system
Section 60
Establishment of reasonable and adequate payment rates; cost reporting
Section 70
Revaluation of assets
Section 80
Refund of overpayments
Section 90
Reimbursement of certified hospitals exempt from Medicare Prospective Payment system
Section 100
Reimbursement of return on equity capital to proprietary providers
Section 110
Group ceiling for state-owned university teaching hospitals
Section 120
[Repealed]
Section 130
Payment adjustment fund
Section 140
[Repealed]
Section 150
Methods and standards for establishing payment rates - inpatient hospital care: Dispute resolution for state-operated providers
Section 160
[Reserved]
Section 200
[Repealed]
Section 201
Application of payment methodologies
Section 210
[Repealed]
Section 220
[Repealed]
Section 221
General
Section 230
[Repealed]
Section 231
Operating payment for DRG cases
Section 240
[Repealed]
Section 241
Operating payment for per diem cases
Section 250
[Repealed]
Section 251
Operating payment for transfer cases
Section 260
[Repealed]
Section 261
Outlier operating payment
Section 270
[Repealed]
Section 271
Payment for capital costs
Section 280
[Repealed]
Section 281
Payment for direct medical education costs of nursing schools, paramedical programs, and graduate medical education for interns and residents
Section 290
[Repealed]
Section 291
Payment for indirect medical education costs
Section 300
[Repealed]
Section 301
Payment to disproportionate share hospitals
Section 310
[Repealed]
Section 311
Hospital specific operating rate per case
Section 320
[Repealed]
Section 321
Hospital specific operating rate per day
Section 330
[Repealed]
Section 331
Statewide operating rate per case
Section 340
[Repealed]
Section 341
Statewide operating rate per day
Section 350
[Repealed]
Section 351
Updating rates for inflation
Section 360
[Repealed]
Section 361
Base year standardized operating costs per case
Section 370
[Repealed]
Section 371
Base year standardized operating costs per day
Section 380
[Repealed]
Section 381
DRG relative weights and hospital case-mix indices
Section 390
[Repealed]
Section 391
Recalibration and rebasing policy
Section 400
Determination of per diem rates
Section 410
State university teaching hospitals
Section 415
Reimbursement for freestanding psychiatric hospital services under EPSDT
Section 417
Reimbursement for inpatient psychiatric services in residential treatment facilities (Level C) under EPSDT
Section 418
Reimbursement for residential and inpatient substance use treatment services
Section 420
Reimbursement of noncost-reporting general acute care hospital providers
Section 425
Supplemental payments for non-state-government-owned hospitals for inpatient services
Section 426
[Repealed]
Section 428
Supplemental payments for private hosptial partners of Type One hospitals
Section 430
Medicare upper limit
Section 435
Lump sum payment
Section 440
[Repealed]
Section 441
Public comment process
Section 450
Cost reporting requirements
Section 460
Hospital settlement
Section 470
Underpayments
Section 480
Refund of overpayments
Section 490
Medicaid Hospital Payment Policy Advisory Council
Section 500
Outlier methodology illustration
FORMS
FORMS (12VAC30-70)
DIBR
DOCUMENTS INCORPORATED BY REFERENCE (12VAC30-70)

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