10A NCAC 22R .0103      ELIGIBLE HOSPITAL

An institution licensed by the State of North Carolina that meets the definition in G.S. 131E-176 (13) is eligible for reimbursement from the Hospital Uncompensated Care Fund if it:

(1)           is not a public agency qualified to certify expenditures in accordance 42 CFR 433.51(b), which is incorporated by reference in 10A NCAC 22Q .0102;

(2)           received payment for more than 50 percent of their Medicaid inpatient discharges under the North Carolina Medicaid State Plan, Attachment 4.19-A discharge Diagnosis Related Groups methodology for the most recent payment period;

(3)           files with the Department 90-days prior to the date of payment under this Subchapter forms prescribed by the Department attesting to the hospital's:

(a)           qualification for disproportionate share status of the "Disproportionate Share Hospital (DSH) Payment" section of the North Carolina Medicaid State Plan, Attachment 4.19-A;

(b)           unreimbursed charges and payments for outpatient services provided to uninsured patients; and

(c)           aggregate Medicaid outpatient cost-to-charge.

History Note:        Authority G.S. 108A-54; 143C-9-9;

Temporary Adoption Eff. December 29, 2021;

Eff. August 1, 2022.