20 CAR § 577-103 – Fee assessment, billing, collection

(a) Each nursing facility shall file a report with the Department of Human Services by the tenth of each month for the preceding month, listing the patient midnight census as required by rules promulgated by the Division of Medical Services.
(b)
1. (1) Accounts receivable will calculate the quality assurance fee by multiplying patient midnight census as reported by the facilities for the previous month by the appropriate rate per period.
2. (2) Billing will be sent no later than the fifteenth of each month.
3. (3) A copy of the patient census report and statement will be forwarded to the division.
4. (4) The fee shall then be due and payable for the previous month by the thirtieth of the month.
(c) From the effective date of the Acts 2001, No. 635, March 9, 2001, to June 30, 2001, the rate shall be set at five dollars and twenty-five cents ($5.25) multiplied by the midnight census count for of all nursing facilities in this state, for each month of this period.
(d)
1. (1) Failure of any nursing facility to file required reports and/or pay fees on a timely basis may result in the withholding of Medicaid reimbursement, license nonrenewal, letters of caution, sanctions, and/or fines.
2. (2) The fine shall be at least ten thousand dollars ($10,000) but no more than twenty thousand dollars ($20,000).
3. (3) The fine and outstanding quality assurance fee shall accrue interest at the maximum rate permitted by law from the date the quality assurance fee is due until payment of the quality assurance fee and the fine.
4. (4) Accounts receivable will initiate the collection process on the first of the month following the due date for payments not postmarked by close of business on the thirtieth of the month.
5. (5) Outstanding accounts report will be forwarded to the division for determination of further action.