§ 14166.18
679 words·~3 min read·
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(a)With respect to each project year, the director shall determine a baseline funding amount for each nondesignated public hospital that was an eligible hospital under paragraph
(3)of subdivision
(a)of Section 14105.98 for both the 2004–05 fiscal year and the project year. A hospital’s baseline funding amount shall be an amount equal to the total amount paid to the hospital for inpatient hospital services rendered to Medi-Cal beneficiaries during the 2004–05 fiscal year, including the following Medi-Cal payments, but excluding payments received under the Medi-Cal Specialty Mental Health Services Consolidation Program:
(1)Base payments under the selective provider contracting program as provided for under Article 2.6 (commencing with Section 14081) or the Medi-Cal state plan cost reimbursement system for inpatient hospital services for noncontracting hospitals.
(2)Emergency Services and Supplemental Payments Fund payments as provided for under Section 14085.6.
(3)Medi-Cal Medical Education Supplemental Payment Fund payments and Large Teaching Emphasis Hospital and Children’s Hospital Medi-Cal Medical Education Supplemental Payment Fund payments as provided for under Sections 14085.7 and 14085.8, respectively.
(4)Small and Rural Hospital Supplemental Payments Fund payments as provided for under Section 14085.9.
(5)Disproportionate share hospital payment adjustments as provided for under Section 14105.98.
(6)Administrative day payments as provided for under Section 51542 of Title 22 of the California Code of Regulations.
(b)The baseline funding amount for each nondesignated public hospital shall reflect a reduction for the total amount of intergovernmental transfers made pursuant to Sections 14085.6, 14085.7, 14085.8, 14085.9, and 14163 for the 2004–05 state fiscal year by the nondesignated public hospital, or on its behalf by the governmental entity with which it is affiliated.
(c)The aggregate nondesignated public hospital baseline funding amount shall be the sum of all baseline funding amounts determined under subdivision (a), as adjusted by subdivision (b).
(d)With respect to each project year beginning after the 2005–06 project year, an aggregate nondesignated public hospital adjusted baseline funding amount shall be determined as follows:
(1)The department shall determine the aggregate total Medi-Cal revenue, using amounts determined under subdivision (a), as adjusted by subdivision (b), but excluding the reductions for the amount of intergovernmental transfers made pursuant to Section 14163, with respect to inpatient hospital services rendered during the 2004–05 fiscal year, for nondesignated public hospitals that were eligible hospitals under paragraph
(3)of subdivision
(a)of Section 14105.98 for the project year, less the total amount of disproportionate share hospital payments identified in paragraph
(5)of subdivision
(a)for those hospitals.
(2)The department shall determine the aggregate total Medi-Cal revenue paid or payable for inpatient hospital services rendered during the fiscal year preceding the project year for which the nondesignated public hospital adjusted baseline funding amount is being calculated for the nondesignated public hospitals described in paragraph (1). The aggregate total revenue for services rendered in the particular preceding fiscal year shall include the payments that are described under paragraphs
(1)and
(6)of subdivision (a), and all other payments made to nondesignated public hospitals under this article, excluding disproportionate share hospital payments pursuant to Section 14166.16, stabilization funding pursuant to Section 14166.19, and distressed hospital funding pursuant to Section 14166.23 and paragraph
(3)of subdivision
(b)of Section 14166.20.
(3)The department shall:
(A)Calculate the difference between the amount determined under paragraph
(1)and the amount determined under paragraph (2).
(B)Determine the percentage increase or decrease by dividing the difference in subparagraph
(A)by the amount in paragraph (1).
(C)Apply the percentage determined in subparagraph
(B)to the amount that results from both of the following:
(i)Aggregating the nondesignated public hospital baseline funding amounts determined under subdivision (a), as adjusted by subdivision (b), but excluding the reductions for the amount of intergovernmental transfers made pursuant to Section 14163.
(ii)Subtracting from the amount in clause
(i)the total amount of disproportionate share hospital payments in paragraph
(5)of subdivision
(a)for those hospitals.
(D)The aggregate nondesignated public hospital adjusted baseline funding amount is the amount determined in subdivision (c), plus the resulting product determined in subparagraph (C).