42 C.F.R. 42 CFR--PART 412
Title 42 - Public Health
Effective Date(s): October 1, 2006 3. In §412.624, paragraphs (e)(5) and (f)(2)(v) are revised to read as follows: * * * * * (e) * * * (5) Adjustment for high-cost outliers. CMS provides for an additional payment to an inpatient rehabilitation facility if its estimated costs for a patient exceed a fixed dollar amount (adjusted for area wage levels and factors to account for treating low-income patients, for rural location, and for teaching programs) as specified by CMS. The additional payment equals 80 percent of the difference between the estimated cost of the patient and the sum of the adjusted Federal prospective payment computed under this section and the adjusted fixed dollar amount. Effective for discharges occurring on or after October 1, 2003, additional payments made under this section will be subject to the adjustments at §412.84(i), except that CMS calculates a single overall (combined operating and capital) cost-to-charge ratio and national averages that will be used instead of statewide averages. Effective for discharges occurring on or after October 1, 2003, additional payments made under this section will also be subject to adjustments at §412.84(m), except that CMS calculates a single overall (combined operating and capital) cost-to-charge ratio. * * * * * (f) * * * (2) * * * (v) By applying the adjustments described in paragraphs (e)(1), (e)(2), (e)(3), (e)(4), and (e)(7) of this section to the unadjusted payment amount determined in paragraph (f)(2)(iv) of this section to equal the adjusted transfer payment amount. * * * * *
Amendment from August 18, 2006
42 CFR--PART 412
Amendment(s) published August 18, 2006, in 71 FR 48408
§ 412.624 Methodology for calculating the Federal prospective payment rates.
