Missouri § 208.471 - Medicaid reimbursement payments to hospitals, amount, how calculated.

§ 208.471. Medicaid reimbursement payments to hospitals, amount, how calculated.

1.  The department of social services shall make payments to those hospitals which have a Medicaid provider agreement with the department.

2.  In each state fiscal year, the amount of federal reimbursement allowance levied under sections 208.450^* to 208.482 shall not exceed forty-five percent of the total payments to hospitals from the federal reimbursement allowance fund and associated federal match, including payments made to hospitals from state-contracted managed care organizations that are attributed to the federal reimbursement allowance fund and associated federal match.  By October first of each subsequent state fiscal year, the department shall report this calculation and the underlying data supporting the calculation to the budget committee of the house of representatives and the appropriations committee of the senate.  The underlying data shall include the amount of federal reimbursement allowance assessment levied on the hospitals and the total amount of Medicaid payments to hospitals funded by the federal reimbursement allowance, including payments made to hospitals from all state-contracted managed care organizations in aggregate.  Payments made by the department to hospitals and payments made, in aggregate, by all state-contracted managed care organizations to hospitals shall be reported separately.  Expenditures reported by the department and all state-contracted managed care organizations in aggregate shall be broken down by fund source, inpatient or outpatient category of service, and individual hospital.  In addition, the department shall separately and concurrently disclose the amount of hospital payments made by the department and the amount of hospital payments made by each of the managed care plans, with the payment data broken down by plan, fund source, inpatient or outpatient category of service, and individual hospital, to the hospitals receiving such payments specific to that hospital or to an organization designated by such hospitals to receive such data and as otherwise authorized or required by law.  Such payment data shall otherwise be regarded as proprietary and confidential under subdivision (15) of section 610.021.

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(L. 1992 H.B. 1744 § 208.450, A.L. 2001 H.B. 955, A.L. 2014 H.B. 1299 Revision, A.L. 2018 S.B. 775)

Expires 9-30-29; see § 208.480

*Section 208.450 was repealed by H.B. 1362, 1994.

---- end of effective  28 Aug 2018 ----

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