Regulation detail

22-A5502

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22-A5502 ANNUAL ADJUSTMENT

Jurisdiction: DC Agency: DC Department of Behavioral Health (DBH) — Title 22-A; and DC Department of Health Care Finance (DHCF) — Title 29 Medicaid behavioral-health chapters
PSYCH_FACILITY (60%)
Plain-English summary

This regulation governs the annual adjustment of per diem charges for a facility that files Medicare cost reports with CMS. When a new annual Medicare cost report is filed with the Fiscal Intermediary (Highmark), the per diem charge must be updated to reflect changes in the cost of care, based on the most recently filed report. Compliance staff should ensure that per diem rates are recalculated and updated each time a new Medicare cost report is submitted.

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Regulation text
5502 ANNUAL ADJUSTMENT 

5502.1 The per diem charge shall be adjusted when a new annual Medicare cost report is filed with the Centers for Medicare and Medicaid Services’ (CMS) Fiscal Intermediary (FI) Highmark to reflect changes in cost of care.

5502.2 The adjusted per diem charge shall be based on the most recently filed Medicare cost report.

 Source: Notice of Final Rulemaking published at 57 DC12222, 12223 (December 24, 2010)