![]() Hospital-specific disproportionate share hospital payment limit: Determination of individuals without health insurance or other third party coverage. ![]() Medicaid disproportionate share hospital (DSH) allotment reductions. Payment Adjustments for Hospitals That Serve a Disproportionate Number of Low-Income Patients Hospital providers of NF services (swing-bed hospitals). Inpatient services: Application of upper payment limits. Procedures for CMS action on assurances and State plan amendments.įFP: Conditions relating to institutional reimbursement. Payment for Inpatient Hospital and Long-Term Care Facility Services Public notice of changes in Statewide methods and standards for setting payment rates. Medicaid provider participation and public process to inform access to care. ![]() Options for claiming FFP payment for section 1920A presumptive eligibility medical assistance payments.įFP: Conditions related to pending investigations of credible allegations of fraud against the Medicaid program.ĭocumentation of access to care and service payment rates. Limitations on premiums and cost sharing.īeneficiary and public notice requirements. Premiums and cost sharing: Basis and purpose.Ĭost sharing for services furnished in a hospital emergency department. Payments for reserving beds in institutions. Withholding Medicare payments to recover Medicaid overpayments. Withholding the Federal share of payments to Medicaid providers to recover Medicare overpayments. Prohibition on payment for provider-preventable conditions. Provider restrictions: State plan requirements.ĭirect payments to certain beneficiaries for physicians' or dentists' services. Prohibition against reassignment of provider claims.Īcceptance of State payment as payment in full.
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