Common use of Determination of Payment Amounts Clause in Contracts

Determination of Payment Amounts. The amount that each non-governmental hospital receives as an initial DSH payment from the pool for which it qualifies is determined by a weighting method that considers both the amounts/points over the Group threshold and the volume of services. The volume of services is either measured by Title XIX days or net inpatient revenue, depending upon the group being considered. There are ten steps to determining the DSH payment amount for non-governmental hospitals that only qualify for Group 1 or Group 2 (and not Group 1A or 2A). After determining the initial DSH payment amount through the ten step process, there is a final adjustment that may be made depending on the result of the hospital’s OBRA limit.

Appears in 2 contracts

Sources: Medicaid Demonstration Agreement, Medicaid Demonstration Agreement