Ch. 30, § 10. Reimbursement of Capital Costs

(a) The Department shall calculate capital payment for eligible APR DRG services as follows: (i) Using the per discharge capital payment rate determined for non-rehabilitation levels of care during the 2010 level of care rebasing; (ii) Calculating the allowable capital cost for each participating hospital using hospitals' as-filed Medicare cost reports for hospital fiscal years ending in state fiscal years 2005 and 2006 and hospitals' inpatient claims paid in state fiscal years 2006 and 2007; (iii) Calculating a capital cost per discharge for each participating hospital by dividing total capital costs by total discharges; and (iv) Arraying the average capital cost per discharge of all participating hospitals and selecting the median capital cost per discharge for the capital payment rate for all participating hospitals. (b) Capital payment for eligible rehabilitation services shall be calculated as follows: (i) The Department shall use the per discharge capital payment rate determined for the rehabilitation level of care; (ii) The Department shall identify the per diem capital payment by dividing the median capital cost per discharge by the average length of stay of all participating hospitals with rehabilitation services discharges; and (iii) The capital payment amount for rehabilitation services may not exceed the per discharge amount calculated. (c) An adjustment to a provider's capital rate shall not result in the redetermination of the statewide average prospective capital rate. (d) The Department shall not make a capital payment to a non-participating provider. (e) A provider may request an adjustment of its capital rate only to compensate for capital expenditures resulting from extraordinary circumstances. (f) A redetermination pursuant to this subsection is effective 30 days after the Department issues a notice of rate adjustment. (g) The statewide base year capital rate shall not be adjusted to reflect adjustments to hospital-specific rates pursuant to this subsection. (h) Capital rates shall not be inflated.