Idaho Admin. Code r. 16.03.09.361

Current through September 2, 2024
Section 16.03.09.361 - APPLICATION
01.Determination of Common Ownership or Control in the Provider Organization and Supply Organization. In determining whether a provider organization is related to a supplying organization, the tests of common ownership and control are to be applied separately. If the elements of common ownership or control are not present in both organizations, the organizations are deemed not to be related to each other.
a. Common Ownership Rule. A determination as to whether an individual(s) possesses ownership or equity in the provider organization and the supplying organization, so that the organizations will be considered to be related by common ownership, will be made on the basis of the facts and circumstances in each case.
b. Control Rule. The term "control" includes any kind of control whether or not it is legally enforceable and however it is exercisable or exercised. It is the reality of the control that is decisive, not its form or the mode of its exercise.
02.Cost to Related Organizations. The charges to the provider from related organizations may not exceed the billing to the related organization for these services.
03.Costs Not Related to Patient Care. All home office costs not related to patient care are not allowable under the Program.
04.Interest Expense. Generally, interest expense on loans between related entities will not be reimbursable. See Chapters 2, 10, and 12, PRM, for specifics.

Idaho Admin. Code r. 16.03.09.361

Effective March 17, 2022