Ariz. Admin. Code § R9-22-712.80 - DRG Reimbursement: New Hospitals
A. DRG base payment for new hospitals. For
any hospital that does not have a labor share or wage index published by CMS as
described in section
R9-22-712.62(B)
because the hospital was not in operation, the DRG base rate described in
section
R9-22-712.62(B)
shall be calculated as the statewide standardized amount after adjusting that
amount for the labor-related share and the wage index published by CMS as
described in section
R9-22-712.62(B)
that is appropriate to the location of the hospital published by CMS as
described in section R9-22-712.62(B).
B. Outlier calculations for new hospitals.
For any hospital that does not have an operating cost-to-charge ratio listed in
the impact file described in section R9-22-712.68(B) because the hospital was
not in operation prior to the publication of the impact file, the statewide
urban or rural default operating cost-to-charge ratio appropriate to the
location of the hospital and the statewide capital cost-to-charge ratio shall
be used to determine the unadjusted outlier add-on payment. The statewide urban
or rural default operating cost-to-charge ratio and the statewide capital
cost-to-charge ratio shall be based on the ratios published by CMS and updated
by the Administration as described in section
R9-22-712.68(C).
C. In addition to the requirement of this
section, DRG reimbursement for new hospitals is determined under
R9-22-712.60 through
R9-22-712.79.
Notes
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