(a)(1) For visits and services beginning October 1, 2019, quarterly Medicaid outpatient hospital access payments shall be made to each private hospital.

(2) Each payment will be equal to the hospital's District Fiscal Year outpatient Medicaid payments divided by the total in District private hospital [outpatient Medicaid payments] for the District Fiscal Year 3 years prior to the current fiscal year multiplied by 1/4 of the total outpatient private hospital access payment pool.

(3) The total outpatient private hospital access payment pool is equal to the total available spending room under the private hospital outpatient Medicaid upper payment limit for each District Fiscal Year.

(b)(1) For visits and services beginning October 1, 2019, outpatient hospital access payments shall be made to the United Medical Center.

(2) Each payment shall be equal to 1/4 of the total outpatient public hospital access payment pool.

(3) The total outpatient public hospital access payment pool is equal to the total available spending room under the District-operated hospital outpatient Medicaid upper payment limit for each District Fiscal Year.

(c) The quarterly Medicaid outpatient hospital access payments shall be made within 15 business days after the end of each DFY quarter for the Medicaid visits and services rendered during that quarter.

(d) No payments shall be made under this section until such time that the Centers for Medicare and Medicaid Services approves the Medicaid State Plan amendment authorizing the Medicaid payments described in this subchapter.

(e) The Medicaid payment methodologies authorized under this subchapter shall not be altered in any way unless such alteration is necessary to gain federal approval from the Centers for Medicare and Medicaid Services.

(Dec. 13, 2017, D.C. Law 22-33, § 5066, 64 DCR 7652; Oct. 30, 2018, D.C. Law 22-168, § 5032(d), 65 DCR 9388; Sept. 11, 2019, D.C. Law 23-16, § 5082(d), 66 DCR 8621.)

For temporary (90 days) amendment of this section, see § 5032(d) of Fiscal Year 2019 Budget Support Congressional Review Emergency Act of 2018 (D.C. Act 22-458, Oct. 3, 2018, 65 DCR 11212).

For temporary (90 days) amendment of this section, see § 5032(d) of Fiscal Year 2019 Budget Support Emergency Act of 2018 (D.C. Act 22-434, July 30, 2018, 65 DCR 8200).

For temporary (90-day) creation of this section, see § 5066 of the Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017, effective October 24, 2017 (D.C. Act 22-167; 64 DCR 10802).

For temporary (90-day) creation of this section, see § 5066 of the Fiscal Year 2018 Budget Support Emergency Act of 2017, effective July 20, 2017 (D.C. Act 22-104; 64 DCR 7032).