20-77-1901. Definitions.

20-77-1901. Definitions. As used in this subchapter: (1) “Division” means the Division of Medical Services of the Department of Human Services; (2) “Hospital” means a health care facility licensed as a hospital by the Division of Health Facilities Services under § 20-9-213; (3) “Medicare Cost Report” means CMS-2552-96, the Cost Report for Electronic Filing of Hospitals, as it existed on January 1, 2009; (4) “Net patient revenue” means the amount calculated in accordance with generally accepted accounting principles for hospitals that is reported on Worksheet G-3, Column 1, Line 3, of the Medicare Cost Report adjusted to exclude nonhospital revenue; (5)(A) “Nonstate government-owned hospital” means a hospital that is owned and operated by an agency or a unit of a county or municipal government, including without limitation a hospital owned and operated by: (i) A county under § 14-263-101 et seq.; or (ii) A city under § 14-264-101 et seq. (B) “Nonstate government-owned hospital” does not include a hospital that is owned by an agency or unit of county or municipal government but is contracted or leased to an individual, firm, or corporation that is not a government entity; (6) “Privately operated hospital” means a licensed hospital in Arkansas other than: (A) Any hospital that is owned and operated by the United States Government; (B) Any hospital that is an agency or a unit of state government, including without limitation a hospital owned by a state agency or a state university; and (C) Any nonstate government-owned hospital; (7) “Specialty hospital” means an acute care general hospital that: (A) Limits services primarily to children and qualifies as exempt from the Medicare prospective payment system regulation; or (B) Is primarily or exclusively engaged in the care and treatment of patients with cardiac conditions; (8) “State plan amendment” means a change or update to the state Medicaid plan; (9) “Upper payment limit” means the maximum ceiling imposed by federal regulation on privately owned hospital Medicaid reimbursement for inpatient services under 42 C.F.R § 447.272 and outpatient services under 42 C.F.R § 447.321; and (10)(A) “Upper payment limit gap” means the difference between the upper payment limit and Medicaid payments not financed using hospital assessments made to all privately operated hospitals. (B) The upper payment limit gap shall be calculated separately for hospital inpatient and outpatient services. (C) Medicaid disproportionate share payments shall be excluded from the calculation of the upper payment limit gap.