10A NCAC 22G .0109       PROVIDER ASSESSMENT

(a)  In accordance with 42 USC 1396b(w) and 42 CFR, Part 433, Subpart B; and consistent with the CMS Federal Waiver approved April 5, 2004 with an effective date of October 1, 2003 including subsequent amendments and revisions, a monthly nursing facility assessment based on all occupied nursing facility bed days of service is imposed on all nursing bed days in licensed nursing facilities, except:

(1)           Any nursing facility bed day of service provided by a Continuing Care Retirement Community (CCRC), as defined by GS 58-64 and licensed by the North Carolina Department of Insurance;

(2)           Any nursing facility bed day of service paid for under the Medicare program established under Title XVIII of the Social Security Act.

A copy of the Waiver may be obtained by contacting the Division of Medical Assistance, 2501 Mail Service Center, Raleigh, North Carolina 27699-2501, (919) 857-4016.

(b)  Effective October 1, 2003, the assessment is payable monthly and due to the Department of Health and Human Services or designee of the Department within 15 days of the last day of the reporting month. Facilities shall submit payment and an account of all actual patient days during the month. Failure to provide accurate and timely reporting of days and payment of assessment shall result in a 10% reduction in facility rates for Medicaid participating facilities and recoupment per the Department Cash Management Plan.

 

History Note:        Authority G.S. 108A-25(b); 108A-54; 108A-55; S.L. 2003-284, Sec. 10.28; CMS Waiver approved April 5, 2004; 42 CFR Part 433, Subpart B;

Temporary Adoption Eff. August 3, 2004;

Eff. January 1, 2005.