The following definitions apply in this Article:
(1) CMS. - Centers for Medicare and Medicaid Services.
(2) Critical access hospital. - Defined in 42 C.F.R. 400.202.
(3) Department. - The Department of Health and Human Services.
(4) Equity assessment. - The assessment payable under G.S. 108A-123.
(5) Medicaid equity payment. - The amount required to be paid under G.S. 108A-124.
(6) Public hospital. - A hospital that certifies its public expenditures to the Department pursuant to 42 C.F.R. 433.51(b) during the fiscal year for which the assessment applies.
(7) Secretary. - The Secretary of Health and Human Services.
(8) State's annual Medicaid payment. - For an assessment collected under this Article, an amount equal to twenty-five and nine-tenths percent (25.9%) of the total amount collected under the assessment.
(9) Total hospital costs. - The costs as calculated using the most recent available Hospital Cost Report Information Systems cost report data, available through CMS, or other comparable data.
(10) Upper pay limit (UPL). - The maximum ceiling imposed by federal regulation on hospital Medicaid payments under 42 C.F.R. 447.272 for inpatient services.
(11) UPL assessment. - The assessment payable under G.S. 108A-123.
(12) UPL gap. - The difference between the UPL attributable to hospital inpatient services and the reasonable costs of inpatient hospital services as defined in Section (f)(2)(A) on page 11 of Attachment 4.19-A of the State Medicaid Plan as approved on December 15, 2005.
(13) UPL payment. - The amount required to be paid under G.S. 108A-124. (2011-11, s. 1; 2013-360, s. 12H.19(a).)
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Last modified: March 23, 2014