42-9-102. Definitions.

(a) As used in this chapter:

(i) "Account" means the private hospital assessment account created by W.S. 42-9-103;

(ii) "Department" means the department of health;

(iii) "Fiscal year" means the twelve (12) month period beginning October 1 and ending September 30;

(iv) "Medicaid" means the medical assistance program established by title XIX of the federal Social Security Act and administered in this state by the department pursuant to the Wyoming Medical Assistance and Services Act;

(v) "Medicare cost report" means the annual hospital cost report as determined by the centers for medicare and medicaid services and as reported to the health care cost report information system;

(vi) "Net hospital patient revenue" means gross hospital revenue as reported on the most recently filed medicare cost report, excluding estimated nonhospital ancillary revenue, multiplied by the hospital s ratio of total net to gross revenue. The department shall establish a procedure to reconcile filed cost report information with information from the settled cost report. If a hospital does not file a medicaid cost report, the department shall establish a procedure to determine what the hospital would have reported as net patient hospital revenue if the hospital had filed a medicaid cost report;

(vii) "Private hospital" means those institutions licensed by the department as hospitals which are not owned or operated by the state or any city, town, county, special district or other political subdivision of the state or local government;

(viii) "Quarterly adjustment payment" means the payment made to private hospitals pursuant to W.S. 42-9-106;

(ix) "Upper payment limit" means the applicable limitation established pursuant to 42 C.F.R. 447.272, 42 C.F.R. 447.321 or as otherwise established by the centers for medicare and medicaid services;

(x) "Upper payment limit gap" means the amount calculated annually by the department constituting the difference between the applicable upper payment limit and medicaid payments made subject to that limit in a fiscal year, excluding any quarterly adjustment payments authorized by this chapter.