§ 904. Rate setting
(a) The Director shall establish by rule procedures for determining payment rates for care of State-assisted persons to nursing homes and to such other providers as the Secretary shall direct. The Secretary shall have the authority to establish rates that the Secretary deems sufficient to ensure that the quality standards prescribed by section 7117 of this title are maintained, subject to the provisions of section 906 of this title. Beginning in State fiscal year 2003, the Medicaid budget for care of State-assisted persons in nursing homes shall employ an annual inflation factor which is reasonable and which adequately reflects economic conditions, in accordance with the provisions of Section 5.8 of the regulations promulgated by the Division of Rate Setting ("Methods, Standards, and Principles for Establishing Medicaid Payment Rates for Long-Term Care Facilities").
(b) No payment shall be made to any nursing home, on account of any State-assisted person, unless the nursing home is certified to participate in the State/federal medical assistance program and has in effect a provider agreement. (Added 1977, No. 204 (Adj. Sess.), § 1; amended 1981, No. 224 (Adj. Sess.), § 1, eff. May 4, 1982; 1989, No. 267 (Adj. Sess.), § 2, eff. July 1, 1991; 1995, No. 160 (Adj. Sess.), § 12; 1997, No. 61, § 270a; 2001, No. 63, § 99; 2013, No. 131 (Adj. Sess.), § 19, eff. May 20, 2014.)
Copyright ©2024 LegalFix. All rights reserved. LegalFix is not a law firm, is not licensed to practice law, and does not provide legal advice, services, or representation. The information on this website is an overview of the legal insurance products you can purchase—or that may be provided by your employer as an employee benefit or by your credit union or other membership group as a membership benefit.
LegalFix provides its members with access to legal services through a network of provider law firms. LegalFix, its corporate entity, and its officers, directors, employees, agents, and contractors do not provide legal advice, services, or representation—directly or indirectly.
The articles and information on the site are not legal advice and should not be relied upon—they are for information purposes only. You should become a LegalFix member to get legal services from one of our provider law firms.
You should not disclose confidential or potentially incriminating information to LegalFix—you should only communicate such information to your provider law firm.
The benefits and legal services described in the LegalFix legal plans are not always available in all states or with all plans. See the legal plan Benefit Overview and the more comprehensive legal plan contract during checkout for coverage details in your state.
Use of this website, the purchase of legal insurance products, and access to the LegalFix network of provider law firms are subject to the LegalFix Terms of Service and Privacy Policy.
