048-10 Wyo. Code R. § 10-5

Current through April 27, 2019
Section 10-5 - Methodology

(a) To insure reimbursement is limited to support of the poor and to prevent duplication of distributions from other payors, the Medicare cost reports from each hospital will be used. Maximum annual reimbursements shall be determined by the Department, Public Health Division, Rural and Frontier Health Unit and in consultation with the Director's Unit for Policy, Research and Evaluation, based on the most recent settled and audited Medicare cost report as of June 1, 2015. The Medicare cost reports shall be retrieved from CMS.gov as publicly reported. A fractional share of the total charity care reported by all eligible hospitals shall be determined.

(b) Quarterly invoices will be submitted to: Rural and Frontier Health; Attn: Laura Hurst; 6101 Yellowstone Road, Ste. 420, Cheyenne, WY 82002 or to laura.hurst@wyo.gov. Invoices shall be due by the last day of the month following each quarter's close: April thru June 2015 due 31 July 2015; July thru September 2015 due 31 October 2015; October thru December 2015 due 31 January 2016; and January thru March 2016 due 30 April 2016. Invoices must reflect the cost of charity care, meaning billed charges with the cost to charge ratio applied, for the preceding quarter only and be accompanied by supporting documentation.

(c) The total available in the fund shall be divided into 2/3 for critical access hospitals, which is $1,333,333.75, and 1/3, which is $666,666.75, for prospective payment system acute care hospitals.

(d) The total cumulative reimbursement per hospital shall not exceed the hospital's respective annual maximum allowable.

(e) If a hospital's quarterly amount to be reimbursed exceeds the annual maximum allowable, the payment shall be reduced to equal the maximum allowed and processed as a final payment. No additional reporting is required from the hospital after a final payment is issued.

(f) Payments shall not be re-determined because of changes to the Medicare cost report or after a payment is processed.

048-10 Wyo. Code R. § 10-5

Adopted, Eff. 10/16/2015.