1. (a) For the purposes of this subchapter, the term:

   1. (1) "Department" means the Department of Health Care Finance.
   2. (2) "District retention" means an amount equal to 13.125% of the fees collected pursuant to § 44-665.13(a)(1), plus the salary and fringe benefits for one full-time equivalent staff position at the Department.
   3. (3) "Fund" means the Outpatient Hospital Directed Payment Provider Fee Fund established by this subchapter.
   4. (4) "Hospital" shall have the same meaning as provided in § 44-501(a)(9); except, that the term "hospital" shall not include a hospital operated by the federal government.
   5. (5) "Hospital system" means a group of hospitals licensed separately, but operated, owned, or maintained by a common entity.
   6. (6) "Medicaid" means the medical assistance programs authorized by Title XIX of the Social Security Act, approved July 30, 1965 (79 Stat. 343; 42 U.S.C. § 1396 et seq.), and by § 1-307.02, and administered by the Department.

   7. (7)

      1. (A) "Outpatient gross patient revenue" means the amount that is reported in column 2 of line 28 of Worksheet G-2 of the hospital's most recently available Hospital and Hospital Health Care Complex Cost Report ("Form CMS 2552-10").
      2. (B) Notwithstanding subparagraph (A) of this paragraph, for a hospital that has not yet filed its first Form CMS-2552-10, the term "outpatient gross patient revenue" shall mean a dollar value determined by the Department, based on projected utilization volume and projected utilization migration from other area hospitals, that approximates the hospital's expected outpatient gross patient revenue.
   8. (8) "State directed payment" means a Medicaid managed care delivery system and provider payment initiative authorized under 42 C.F.R § 438.6(c).

Emergency Legislation

For temporary (90 days) creation of this section, see § 5032 of Fiscal Year 2025 Budget Support Emergency Act of 2024 (D.C. Act 25-506, July 15, 2024, 71 DCR 8406).

History

Sept. 18, 2024, D.C. Law 25-217, § 5032