OAR 410-120-1920: Institutional Reimbursement Changes

(1) The Division of Medical Assistance Programs (Division) is required under federal regulations, 42 CFR 447, to submit specific assurances and related information to the Centers for Medicare and Medicaid Services (CMS) whenever it makes a significant change in its methods and standards for setting payment rates for inpatient hospital services or long-term care facilities. (2) A "significant change" is defined as a change in payment rates that affects the general method of payment to all providers of a particular type or is projected to affect total reimbursement for that particular type of provider by six percent or more during the 12 months following the effective date. (3) Federal regulation specifies that a public notice must be published in one of the following: (a) A state register similar to the Federal Register. For the Oregon Health Authority (Authority), the state register is the Oregon Bulletin published by the Secretary of State; (b) The newspaper of widest circulation in each city with a population of 50,000 or more; (c) The newspaper of widest circulation in the state, if there is no city with a population of 50,000 or more; (d) The Authority web site for public notices.