Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 50 - TAX RULES › Section 410-050-0700 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
The following definitions apply to OAR 410-050-0700  to
				410-050-0870:
(1) "Authority" means
			 the Oregon Health Authority.
(2)
			 "Bad Debt" means the current period charge for actual or expected uncollectible
			 accounts resulting from the extension of credit on inpatient and outpatient
			 hospital services. Bad debt charges shall be offset by any recoveries received
			 on accounts receivable during that current period, subject to final assessment
			 reporting and reconciliation processes required in these rules.
(3) "Charges for Inpatient Care" means gross
			 inpatient charges generated from room, board, general nursing, and ancillary
			 services provided to patients who are expected to remain in the hospital at
			 least overnight and occupy a bed (as distinguished from categories of health
			 care items or services identified in
			 42 CFR
			 433.56(a)(2)-(19) that are
			 not charges for inpatient hospital services). Charges for inpatient care
			 include all payers, and are not limited to Medicaid patients.
(4) "Charges for Outpatient Care" means gross
			 outpatient charges generated from services provided by the hospital to a
			 patient who is not confined overnight. These services include all ancillary and
			 clinic facility charges (as distinguished from categories of health care items
			 or services identified in
			 42 CFR
			 433.56(a)(1) and (3)-(19)
			 that are not charges for outpatient hospital services). Charges of outpatient
			 care include all payers and are not limited to Medicaid charges.
(5) "Charity Care" means costs for providing
			 inpatient or outpatient care services free of charge or at a reduced charge
			 because of the indigence or lack of health insurance of the patient receiving
			 the care services. Charity care results from a hospital's policy as reflected
			 in its official financial statements to provide inpatient or outpatient
			 hospital care services free of charge or at a reduced charge to individuals who
			 meet financial criteria. Charity care does not include any amounts above the
			 payments by the Authority that constitute payment in full under ORS
			 414.065(3),
			 or above the payment rate established by contract with a prepaid managed care
			 health services organization or health insurance entity for inpatient or
			 outpatient care provided pursuant to such contract, or above the payment rate
			 established under ORS
			 414.743 for inpatient or outpatient care reimbursed under that statute.
(6) "Contractual Adjustments" means the
			 difference between the amounts charged based on the hospital's full,
			 established charges and the amount received or due from the payer.
(7) "Declared Fiscal Year" means the fiscal
			 year declared to the Internal Revenue Service (IRS).
(8) "Deficiency" means the amount by which
			 the assessment, as correctly computed, exceeds the assessment, if any, reported
			 and paid by the hospital. If, after the original deficiency is assessed,
			 subsequent information shows the correct amount of assessment to be greater
			 than previously determined, an additional deficiency arises.
(9) "Delinquency" means the hospital fails to
			 file a report when due as required under these rules or fails to pay the
			 assessment as correctly computed when the assessment was due.
(10) "Director" means the Director of the
			 Authority.
(11) "Hospital" means a
			 hospital licensed under ORS chapter 441. Hospital, as used in this section,
			 does not include special inpatient care facilities as that term is defined in
			 ORS
			 442.015,
			 hospitals that provide only psychiatric care, pediatric specialty hospitals
			 providing care to children at no charge, and public hospitals other than
			 hospitals created by health districts under ORS
			 440.315 to
			 440.410. For
			 purposes of these rules, the hospital shall be identified by using the federal
			 payer identification number for the hospital.
(12) "Net Revenue" means the total amount of
			 charges for inpatient or outpatient care provided by the hospital to patients,
			 less charity care, bad debts, and contractual adjustments. Net revenue does not
			 include revenue derived from sources other than inpatient or outpatient
			 operations including but not limited to interest and guest meals and any
			 revenue that is taken into account in computing a long-term care assessment
			 under the long-term facility assessment.
(13) "Type A Hospital" means a small remote
			 hospital that has 50 or fewer beds and is more than 30 miles from another acute
			 inpatient care facility.
(14) "Type
			 B Hospital" means a small and rural hospital that has 50 or fewer beds and is
			 30 miles or less from another acute inpatient care facility.
Note: Publications referenced are available from the
				  agency.
Statutory/Other Authority: 413.042
Statutes/Other Implemented: 2017 HB
				  2391