Virginia Administrative Code › Title 12 - HEALTH › Agency 30 - DEPARTMENT OF MEDICAL ASSISTANCE SERVICES › Chapter 70 - METHODS AND STANDARDS FOR ESTABLISHING PAYMENT RATES - INPATIENT HOSPITAL SERVICES › Part V - Inpatient Hospital Payment System › Article 2 - Prospective (DRG-Based) Payment Methodology › Section 12VAC30-70-271 - Payment for capital costs

Current through Register Vol. 40, No. 24, July 15, 2024
A.
					 Inpatient capital costs shall be determined on an allowable cost basis and
					 settled at the hospital's fiscal year end. Allowable cost shall be determined
					 following the methodology described in Supplement 3 (12VAC30-70-10
					 through
					 12VAC30-70-130
					 ).
B. For hospitals with fiscal
					 years that are in progress and do not begin on July 1, inpatient capital costs
					 for the fiscal year in progress shall be apportioned in accordance with
					 subdivisions 1 through 6 of this subsection.
1. Inpatient capital costs apportioned before
					 July 1, 2003, shall be settled at 100% of allowable cost.
2. Effective July 1, 2003, through June 30,
					 2009, inpatient capital costs of Type One hospitals shall be settled at 100% of
					 allowable cost. Inpatient capital costs of Type Two hospitals shall be settled
					 at 80% of allowable cost.
3.
					 Effective July 1, 2009, through June 30, 2010, inpatient capital costs of Type
					 One hospitals shall be settled at 100% of allowable cost. Inpatient capital
					 costs of Type Two hospitals, excluding hospitals with Virginia Medicaid
					 utilization greater than 50%, shall be settled at 75% of allowable cost.
					 Inpatient capital costs of Type Two hospitals with Virginia Medicaid
					 utilization greater than 50% shall be settled at 80% of allowable
					 cost.
4. Effective July 1, 2010,
					 through September 30, 2010, inpatient capital costs of Type One hospitals shall
					 be settled at 97% of allowable costs. Inpatient capital costs of Type Two
					 hospitals, excluding hospitals with Virginia Medicaid utilization greater than
					 50%, shall be settled at 72% of allowable cost. Inpatient capital costs of Type
					 Two hospitals with Virginia Medicaid utilization greater than 50% shall be
					 settled at 77% of allowable cost.
5. Effective October 1, 2010, through June
					 30, 2011, inpatient capital costs of Type One hospitals shall be settled at
					 100% of allowable cost. Inpatient capital costs of Type Two hospitals,
					 excluding hospitals with Virginia Medicaid utilization greater than 50%, shall
					 be settled at 75% of allowable cost. Inpatient capital costs of Type Two
					 hospitals with Virginia Medicaid utilization greater than 50% shall be settled
					 at 80% of allowable cost.
6.
					 Effective July 1, 2011, inpatient capital costs of Type One hospitals shall be
					 settled at 96% of allowable costs. Inpatient capital costs of Type Two
					 hospitals, excluding hospitals with Virginia Medicaid utilization greater than
					 50%, shall be settled at 71% of allowable cost. Inpatient capital costs of Type
					 Two hospitals with Virginia Medicaid utilization greater than 50% shall be
					 settled at 76% of allowable cost.
7. Effective July 1, 2019, inpatient capital
					 rates for critical access hospitals shall be 100% of cost
					 reimbursement.