D.C. Mun. Regs. tit. 29, r. 29-4819

Current through Register Vol. 71, No. 49, December 6, 2024
Rule 29-4819 - SPECIALTY INPATIENT SERVICES: CLAIMS SUBMISSION AND UTILIZATION CONTROL
4819.1

A specialty hospital reimbursed on a per diem basis (PD-APR-DRG) shall be required to submit a final claim using Bill Type 114. DHCF, or its designee, shall retrospectively analyze hospital claims records in order to ensure compliance with this requirement.

4819.2

Specialty hospitals shall comply with federally prescribed utilization control standards, pursuant to 42 C.F.R. part 456 as a condition of receipt of Medicaid reimbursement.

D.C. Mun. Regs. tit. 29, r. 29-4819

Final Rulemaking published at 63 DCR 5234 (4/8/2016)