N.J. Admin. Code § 10:52-4.4

Current through Register Vol. 56, No. 19, October 7, 2024

Section 10:52-4.4 - Basis of payment; hospital capital project adjustment

(a) Any qualifying hospital that has completed a capital facilities construction project with an approved certificate of need from the New Jersey Department of Health, which meet both conditions in (a)1 below will be eligible for increased payments for capital project funding related to its Medicaid/NJ FamilyCare-Plan A managed care utilization.

1. The conditions required in (a) above are:

i. The approval is for a single capital project in excess of $ 20 million, which is for replacement beds, which reduce the number of hospital beds available in the State as of September 15, 1997; and

ii. The hospital has a 1995 percentage of low income revenue greater than 50 percent. The low income revenue percentage shall be based on revenue data as reported on the submitted 1995 New Jersey Hospital Cost Report, after desk audit. The low income revenue percentage shall be based on the sum of the Medicaid revenue as reported on Forms E-5 and E-6, line 1, column E, plus the Charity Care revenue as reported on Forms E-5 and E-6, line 1, column J, divided by the sum of the total revenue as reported on Forms E-5 and E-6, line 1, column M.

2. Payments to eligible hospitals shall begin upon project completion and facility operation.

3. The hospital-specific capital project funding annual amount shall be equal to the principal and interest cost associated with the capital project, multiplied by the Medicaid/NJ FamilyCare -Plan A managed care percent for inpatient services, less any capital costs included in the managed care rates.

N.J. Admin. Code § 10:52-4.4

Amended by 50 N.J.R. 1261(a), effective 5/21/2018