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 D.C. Municipal Regulations (Last Updated: September 13, 2017)
 Title 29. PUBLIC WELFARE
 Chapter 29-48. MEDICAID PROGRAM: REIMBURSEMENT

  Section 29-4804. INPATIENT SERVICES: INDIRECT MEDICAL EDUCATION (IME)  

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    4804.1 For Medicaid reimbursement of inpatient hospital discharges, the amount of the hospital-specific cost per discharge adjusted for IME shall be added to the District-wide base rate for each in-District general hospital to determine the hospital-specific base rate. 

     

    4804.2 The hospital-specific cost per discharge of IME shall be calculated annually as follows:

     

    (a) The hospital-specific cost per discharge adjusted for casemix shall be divided by the IME factor.

     

    (b) For discharges occurring on or after October 1, 2014, the amount calculated in Subsection 4804.2(a) shall be multiplied by a factor of 0.75 to determine the IME payment per discharge for each hospital.

     

    (c) For discharges occurring on or after October 1, 2015, and annually thereafter, the amount calculated in Subsection 4804.2(a) is multiplied by a factor of 0.50 to determine the IME payment per discharge for each hospital.

     

    (d) The amount established pursuant to Subsections 4804.2(b) or (c) shall be subtracted from the average cost per discharge for each hospital before determining the District-wide base rate.

     

     

authority

An Act to enable the District of Columbia to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat. 744; D.C. Official Code § 1-307.02 (2014 Repl.& 2015 Supp.)) and Section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6) (2012 Repl.)).

source

Final Rulemaking published at 45 DCR 4141, 4146 (June 26, 1998); as amended by Final Rulemaking published at 50 DCR 5196 (June 27, 2003); as amended by Emergency and Proposed Rulemaking published at 57 DCR 2691 (March 26, 2010) [EXPIRED]; as amended by Emergency and Proposed Rulemaking published at 57 DCR 6837 (July 10, 2010) [EXPIRED]; as amended by Final Rulemaking published at 58 DCR 4323, 4327 (May 20, 2011); as amended by Final Rulemaking published at 59 DCR 15078 (December 28, 2012); as amended by Final Rulemaking published at 63 DCR 5234 (April 8, 2016).