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Delaware · Through 2026-08-10 (85 Del. Laws, c. 421, 424) · Newer source version available

16 Del. C. § 1166: Medicaid reimbursement.

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Where this section sits in the code
  1. Title 16. Health and Safety
  2. Regulatory Provisions Concerning Public Health
  3. CHAPTER 11. Long-Term Care Facilities and Services
  4. Subchapter VII. Minimum Staffing Levels for Residential Health Facilities

(a) The Medicaid reimbursement program shall be adjusted to reflect costs associated with the increased staffing levels described herein. Reimbursement rates for nursing wages will be adjusted to the seventy-fifth percentile under the current wage determination methodology for primary care under the state Medicaid program.

(b) The Department shall ensure that 100% of Medicaid funds paid for primary care are expended by the residential health facility for primary care purposes. If, during any annual cost reporting period, a facility expends less than 100% of the primary care reimbursement it receives from Medicaid for primary care, the sum under-spent must be repaid to the Medicaid program. The repayment will be made through a cost settlement process when the provider files its annual cost report. The Department will revise its regulations and Medicaid cost report forms to require a cost settlement for the primary care reimbursement classification.

(c) Medicaid reimbursement of providers shall be consistent with the provisions of this chapter regardless of the payment methodology employed by Medicaid or its contractors, including managed care.

Collected 2026-09-05T23:02:20Z. Source file · JSON

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