N.J. Admin. Code § 10:52-5.16

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:52-5.16 - Derivation from Preliminary Cost Base

(a) Apportionment of Financial Elements based on direct costs shall be as follows:

1. All other Financial Elements are added to direct Medicaid/NJ FamilyCare fee-for-service patient care costs as percentages of direct costs per Medicaid/NJ FamilyCare case. The Schedule of Rates is set such that all Medicaid/NJ FamilyCare patients' rates are based on the cost of services received by Medicaid/NJ FamilyCare fee-for-service beneficiaries, including a proportionate share of indirect financial elements requirements of operating hospital facilities.

2. In the event that a hospital is self-insured for employee health benefits, the percentage of personnel health allowance recognized in the rates shall be proportioned to the number of Medicaid/NJ FamilyCare fee-for-service beneficiaries serviced by the facility to financial elements from payers for such costs.

3. Each hospital shall receive from the Division a base rate order detailing the Schedule of Rates.

N.J. Admin. Code § 10:52-5.16

Amended by R.1995 d.141, effective 3/6/1995.
See: 27 New Jersey Register 34(a), 27 New Jersey Register 908(a).
Recodified from N.J.A.C. 10:52-5.20 and amended by R.2000 d.29, effective 1/18/2000.
See: 31 New Jersey Register 3151(a), 32 New Jersey Register 276(a).
In (a), substituted a reference to Medicaid NJ KidCare fee-for-service patient care costs for a reference to Medicaid patient care costs, inserted a reference to NJ KidCare cases, and substituted a reference to Medicaid/NJ KidCare patients' rates for a reference to Medicaid patients' rates in 1, and substituted references to Medicaid and NJ KidCare fee-for-service beneficiaries for references to Medicaid recipients in 1 and 2. Former N.J.A.C. 10:52-5.16, Net income from other sources, recodified to N.J.A.C. 10:52-5.12.
Amended by R.2005 d.214, effective 7/5/2005.
See: 37 New Jersey Register 436(a), 37 New Jersey Register 2506(a).
Substituted "FamilyCare" for "KidCare" throughout.