(A) For purposes of this rule, capital costs include the categories of costs recognized by medicare on the centers for medicare and medicaid services (CMS) 2552-96 revised April 1, 2005, available at http://www.cms.hhs.gov/manuals/pub152/PUB_15_2.asp.
(B) Capital-related costs for Ohio hospitals paid under prospective payment will be subject to reasonable cost reimbursement. The program reimbursable amount will be reconciled during settlement to the total amount of interim capital payments associated with discharges occurring during the cost-reporting period.
(C) Annual update of interim capital payments. The calculation of interim capital payments resulting in the capital allowance identified in paragraph (I) of rule 5101:3-2-07.4 of the Administrative Code is based on the hospital's cost-reporting period.
On an annual basis, the interim capital payments will be redetermined by identifying the capital-related costs reported on CMS 2552-96; multiplying that cost by the per cent of medicaid inpatient charges to total charges; and dividing the result by the number of medicaid discharges that occurred during the cost-reporting period. The cost report used to complete these calculations is the interim settled cost report ending in the state fiscal year ending in the calendar year preceding the immediate past calendar year prior to January first of the calendar year to which the new capital rate shall apply.
(D) Non-Ohio hospital capital reimbursement.
(1) The average statewide capital cost is computed by summing total capital costs for all Ohio hospitals as described in paragraph (C) of this rule, divided by total discharges for all Ohio hospitals as described in paragraph (C)(2) of this rule.
(2) The average statewide capital cost is updated annually using capital costs from cost reports as described in paragraph (C) of this rule.
(3) The amounts derived in paragraph (D)(1) of this rule will reflect a statewide average calculated to be in effect at the beginning of the prospective rate year and not subject to retrospective adjustments.
R.C. 119.032 review dates: 11/10/2005 and 01/01/2011
Promulgated Under: 119.03
Statutory Authority: 5111.02
Rule Amplifies: 5111.02
Prior Effective Dates: 10/1/84, 7/4/85, 7/3/86, 10/19/87, 6/19/00