Ch. 30, § 9. APR DRG Exempt Hospitals

(a) The Department shall reimburse an exempt hospital for its reasonable costs using all-inclusive per diem rates determined on an annual basis, based upon the following: (i) At the beginning of each state fiscal year, the Department shall determine an interim rate using the costs reported in the most recent available Medicare cost report. The rate is calculated by dividing total allowable costs by total days. (ii) The final rates shall cover one hundred per cent of the total allowable costs to treat Medicaid clients. If final rates are greater than the interim rates, the Department shall pay each hospital the difference between the final and interim rates. If final rates are less than the interim rates, the Department shall recover any overpayments.