West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-08 - Legislative Rules For The Limitation On Hospital Gross Patient Revenue › Section 65-8-3 - Gross Patient Revenue To Be AllowedHospitals During The Control Period

Current through Register Vol. XLI, No. 28, July 12, 2024
3.1. General. --
				During the control period, no hospital shall earn gross patient revenues in
				excess of that allowed by the provisions of these rules. The amount of allowed
				gross patient revenue shall be calculated by the hospital and verified by the
				Authority. This calculation shall be made after the end of the hospital's
				fiscal year ending in 1984 and after the Authority sets the initial rate
				schedule for the hospital and shall be reported within one hundred twenty (120)
				days of the end of that fiscal year in a form and manner prescribed by the
				Authority. Any gross patient revenue in excess of that allowed by these rules
				shall be paid to the Authority in a manner prescribed by the Authority. The
				Authority may take into consideration the impact of the amount payable on the
				hospital's solvency in establishing a schedule of payment of excess gross
				patient revenue to the Authority. Payment due the Authority also may be
				assigned by the Authority to future patients by directing a hospital to reduce
				rates.
3.2. Allowed rate of
				increase in gross patient revenue. -- The allowed rate of increase in a
				hospital's gross patient revenue during the control period shall be twelve
				percent (12%) per annum, adjusted for changes in the hospital's proportion of
				Medicare, Medicaid or charity care patients. A set of allowed rates shall be
				calculated for each hospital consisting of a rate for the first twelve (12)
				months of the control period and a rate for the remainder of the control
				period. The rate for the first twelve (12) months shall be based on the
				information reported in the hospital's audited financial statement for the
				fiscal year ending in 1983. The rate for the remaining portion of the control
				period shall be based on the hospital's audited financial statement for the
				fiscal year ending in 1984.
The formulas for calculating the allowed rates of increase
				  are as found in Table 65-8A found at the end of this regulation.
3.3. Calculation of gross patient
				revenue allowed in control period.
3.3.1. The
				amount of gross patient revenue allowed a hospital for the first twelve (12)
				months of the control period shall be the gross patient revenue reported for
				the base period times the sum of one (1) plus the allowed rate of increase for
				the twelve (12) months. (See Table 65-8B at the end of this
				regulation.)
3.3.2. The amount of
				gross patient revenue allowed a hospital for the remaining portion of the
				control period shall be the gross patient revenue allowed for the first twelve
				(12) months times the sum of one (1) plus the allowed rate of increase for
				remaining months of the control period times the ratio of the number of months
				remaining in the control period to twelve (12). (See Table 65-8C at the end of
				this regulation.)
3.3.3. The total
				amount of gross patient revenue allowed a hospital during the control period
				shall be the sum of:
(a) The gross patient
				revenue allowed for the first twelve (12) months (GPR );
(b) The gross patient revenue allowed for the
				remaining portion of the control period (GPR); and
(c) Such amount that the Authority may, upon
				application of a hospital, determine to be necessary as a result of projects
				undertaken in conformance with Certificate of Need approvals or exemptions
				issued in accordance with article two-d, chapter sixteen of the Code.