Section 40-26B-79
Inpatient Medicaid base payments.
If the Medicaid Agency begins making payments pursuant to Article 9 of Chapter 6 of Title 22, on or before September 30, 2019, the agency shall pay hospitals as a base amount for state fiscal year 2019, for inpatient services an APR-DRG payment that is equal to the total modeled UPL submitted and approved by CMS during fiscal year 2019. If the agency begins making payments pursuant to Article 9 of Chapter 6 of Title 22, on a date other than the first day of fiscal year 2019, there shall be no retroactive adjustment to payments already made to hospitals in accordance with the approved state plan. If approved by CMS, the agency shall publish the APR-DRG rates for each hospital prior to September 30, 2018. If the agency does not begin making payments pursuant to Article 9 of Chapter 6 of Title 22, on or before September 30, 2022, the agency shall pay hospitals as a base amount for fiscal years 2020, 2021, and 2022, the total inpatient payments made by the agency during state fiscal year 2007, divided by the total patient days paid in state fiscal year 2007, multiplied by patient days paid during fiscal years 2020, 2021, and 2022. This payment to be paid using the agency's published check write table is in addition to any hospital access payments the agency may elect to pay hospitals inpatient payments other than per diems and access payments, if the agency does not make payments pursuant to Article 9 of Chapter 6 of Title 22 in fiscal year 2019, only if the Hospital Services and Reimbursement Panel approves the change in hospital payments.
(Act 2009-549, p. 1454, §2; Act 2011-615, p. 1383, §1; Act 2013-246, p. 595, §1; Act 2016-299, p. 749, §1; Act 2017-382, §1; Act 2018-543, §1; Act 2019-278, §1.)