§ 4–204.61. Definitions.

DC Code § 4–204.61 (2019) (N/A)

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For the purposes of this part, the term:

(1) “Case mix reimbursement methodology” means a prospective Medicaid payment rate system for nursing facilities that includes:

(A) A point-of-sale prescription system;

(B) A resident classification system based on resident acuity and needs; and

(i) All freestanding nursing facilities, except those owned by the District of Columbia;

(ii) All hospital-based nursing facilities; and

(iii) All nursing facilities owned by the District of Columbia.

(2) “Medicaid” means the medical assistance programs authorized by title XIX of the Social Security Act, approved July 30, 1965 (79 Stat. 343; 42 U.S.C. § 1396 et seq.), and by § 1-307.02, and administered by the Department of Health.

(3) “Nursing facility” means a health care facility as defined in § 44-501(a)(3), but does not include a health care facility operated by the federal government.

(Dec. 7, 2004, D.C. Law 15-205, § 5211, 51 DCR 8441; Mar. 2, 2007, D.C. Law 16-191, § 19, 53 DCR 6794.)

D.C. Law 16-191, in par. (3), validated a previously made technical correction.

For temporary (90 day) addition, see § 5211 of Fiscal Year 2005 Budget Support Emergency Act of 2004 (D.C. Act 15-486, August 2, 2004, 51 DCR 8236).

For temporary (90 day) addition, see § 5211 of Fiscal Year 2005 Budget Support Congressional Review Emergency Act of 2004 (D.C. Act 15-594, October 26, 2004, 51 DCR 11725).

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§ 4–204.62. Medicaid reimbursement system for nursing facilities.