10A N.C. Admin. Code 22R.0103

Current through Register Vol. 39, No. 7, October 1, 2024

Section 22R .0103 - ELIGIBLE HOSPITAL

An institution licensed by the State of North Carolina that meets the definition in G.S. 131E-176(13) is eligible for reimbursement from the Hospital Uncompensated Care Fund if it:

(1) is not a public agency qualified to certify expenditures in accordance 42 CFR 433.51(b), which is incorporated by reference in 10A NCAC 22Q .0102;

(2) received payment for more than 50 percent of their Medicaid inpatient discharges under the North Carolina Medicaid State Plan, Attachment 4.19-A discharge Diagnosis Related Groups methodology for the most recent payment period;

(3) files with the Department 90-days prior to the date of payment under this Subchapter forms prescribed by the Department attesting to the hospital's:

(a) qualification for disproportionate share status of the "Disproportionate Share Hospital (DSH) Payment" section of the North Carolina Medicaid State Plan, Attachment 4.19-A;

(b) unreimbursed charges and payments for outpatient services provided to uninsured patients; and

(c) aggregate Medicaid outpatient cost-to-charge.

10A N.C. Admin. Code 22R .0103

Authority G.S. 108A-54; 143C-9-9;
Temporary Adoption Eff. December 29, 2021;
Eff. August 1, 2022.

Amended by North Carolina Register Volume 37, Issue 05, September 1, 2022 effective 8/1/2022.