Administrative Code

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Virginia Administrative Code
Title 12. Health
Agency 30. Department of Medical Assistance Services

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
Section 130
Payment adjustment fund
Section 140
Section 150
Methods and standards for establishing payment rates - inpatient hospital care: Dispute resolution for state-operated providers
Section 160
Section 200
Section 201
Application of payment methodologies
Section 210
Section 220
Section 221
Section 230
Section 231
Operating payment for DRG cases
Section 240
Section 241
Operating payment for per diem cases
Section 250
Section 251
Operating payment for transfer cases
Section 260
Section 261
Outlier operating payment
Section 270
Section 271
Payment for capital costs
Section 280
Section 281
Payment for direct medical education costs of nursing schools, paramedical programs, and graduate medical education for interns and residents
Section 290
Section 291
Payment for indirect medical education costs
Section 300
Section 301
Payment to disproportionate share hospitals
Section 310
Section 311
Hospital specific operating rate per case
Section 320
Section 321
Hospital specific operating rate per day
Section 330
Section 331
Statewide operating rate per case
Section 340
Section 341
Statewide operating rate per day
Section 350
Section 351
Updating rates for inflation
Section 360
Section 361
Base year standardized operating costs per case
Section 370
Section 371
Base year standardized operating costs per day
Section 380
Section 381
DRG relative weights and hospital case-mix indices
Section 390
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
Section 428
Supplemental payments for private hosptial partners of Type One hospitals
Section 430
Medicare upper limit
Section 435
Lump sum payment
Section 440
Section 441
Public comment process
Section 450
Cost reporting requirements
Section 460
Hospital settlement
Section 470
Section 480
Refund of overpayments
Section 490
Medicaid Hospital Payment Policy Advisory Council
Section 500
Outlier methodology illustration
FORMS (12VAC30-70)

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