NAC422.155. Recalculation after audit; final distribution; recovery and redistribution of payments.

     1. After conducting an audit pursuant to NAC 422.145, the Division will recalculate, based upon the results of the audit, the:

     (a) Uncompensated care costs for each hospital in this State;

     (b) Distribution factor for each hospital and each pool of hospitals; and

     (c) Disproportionate share payments for each hospital by dividing the recalculated distribution factor for that hospital by the pool distribution factor and multiplying the result by the total amount of money available for final distribution to the pool of hospitals pursuant to NAC 422.115.

     2. A hospital may receive as a final distribution of disproportionate share payments for a fiscal year an amount equal to:

     (a) The uncompensated care costs calculated pursuant to paragraph (a) of subsection 1; or

     (b) The disproportionate share payment for the hospital calculated pursuant to paragraph (c) of subsection 1,

Ê whichever is less.

     3. If the amount of the final distribution payment calculated pursuant to subsection 2 is less than the amount of the initial distribution of disproportionate share payments received by the hospital pursuant to NAC 422.135, the hospital shall return to the Division the difference between the amount of the initial distribution and the amount of the final distribution.

     4. Except as otherwise provided in subsection 5, the Division will, for each pool of hospitals, redistribute among the hospitals within the pool the money returned to the Division pursuant to subsection 3 by the hospitals within that pool.

     5. If each hospital within a pool of hospitals has received the maximum amount of disproportionate share payments allowable by federal and state statutes and regulations, the Division will use the money returned pursuant to subsection 3 to pay additional disproportionate share payments as follows:

     (a) If the money was returned by a hospital that is a member of Pool A, to hospitals in Pool B;

     (b) If the money was returned by a hospital that is a member of Pool B, to hospitals in Pool C;

     (c) If the money was returned by a hospital that is a member of Pool C, to hospitals in Pool D;

     (d) If the money was returned by a hospital that is a member of Pool D, to hospitals in Pool E; or

     (e) If the money was returned by a hospital that is a member of Pool E, to hospitals in Pool D,

Ê or, if each hospital in a pool of hospitals to which additional payments would have been paid pursuant to this subsection has received the maximum allowable disproportionate share payments, to such other pool of hospitals as the Division determines appropriate.

     (Added to NAC by Div. of Health Care Fin. & Policy by R033-10, eff. 6-30-2010)