GroundRules
12VAC30-70-331: Statewide operating rate per case
Where this section sits in the code
- Title 12. Health
- Agency 30. Department of Medical Assistance Services
- Chapter 70. Methods and Standards for Establishing Payment Rates; In-Patient Hospital Care
- Part V. Inpatient Hospital Payment System
- Article 2. Prospective (DRG-Based) Payment Methodology
A. The statewide operating rate per case shall be equal to the base year standardized operating costs per case, as determined in 12VAC30-70-361, times the inflation values specified in 12VAC30-70-351 times the adjustment factor specified in subsection B of this section.
B. The adjustment factor shall be determined separately for Type One and Type Two hospitals:
1. For Type One hospitals the adjustment factor shall be a calculated percentage that causes the Type One hospital statewide operating rate per case to equal the Type Two hospital statewide operating rate per case;
2. For Type Two hospitals the adjustment factor shall be:
a. 0.7800 effective July 1, 2006, through June 30, 2010.
b. 0.7500 effective July 1, 2010, through September 30, 2010.
c. 0.7800 effective October 1, 2010.
C. The operating rate for critical access hospitals shall be based on an adjustment factor of 1.0, effective July 1, 2019.
Collected 2026-09-14T04:50:58Z. Source file · JSON