Sec. 10.09.29.13. Interim Rates

A. A provider shall have its interim rate updated annually.

B. A provider's interim rate shall be adjusted at the beginning of each fiscal year, by applying the Centers for Medicare and Medicaid Services' published federal fiscal year market basket index relating to hospitals excluded from the prospective payment system, subject to the limitations in Regulation .07A of this chapter, to the provider's interim rate in effect on the last day of the preceding fiscal year.

C. The rate established in §B of this regulation is in effect until such time as a new rate can be calculated as specified in §§D-F of this regulation.

D. The provider shall submit annually, with the cost report described in Regulation .12 of this chapter, schedules detailing projected increases/decreases from the year just ended to the current year.

E. The provider shall submit a calculation reflecting the rate being requested for the current year.

F. The Department or its designee shall use the submitted cost report, schedules, calculations, and other information as appropriate to calculate an updated interim rate for the current year.

G. The rate established in accordance with §F of this regulation shall be implemented for the remainder of the fiscal year with no retroactive supplemental billing or payment for differences in rates.

H. Providers may request an interim rate revision:

(1) If the revised interim rate exceeds the current rate by 7 percent; and

(2) Not more than two times during a fiscal year.

I. A request for a revised interim rate shall include, at a minimum:

(1) A completed cost report based on a minimum of 3 months of recent actual cost and statistics;

(2) An adjusted trial balance covering the cost report period in §I(1) of this regulation; and

(3) A calculation reflecting the revised rate being requested.

J. A new provider seeking payment for services shall submit to the Department or its designee a projected budgeted cost report and other appropriate information for the period from the beginning of its operations as a provider to the end of its first fiscal year, along with a projected charge rate schedule, for establishment of an initial interim rate by the Department or its designee, subject to the limitations in Regulation .07A of this chapter.