D.C. Mun. Regs. tit. 22-A, § 5502
5502.1 The per diem charge shall be adjusted when a new annual Medicare cost report is filed with the Centers for Medicare and Medicaid Services' (CMS) Fiscal Intermediary (FI) Highmark to reflect changes in cost of care.
5502.2 The adjusted per diem charge shall be based on the most recently filed Medicare cost report.
Source: Notice of Final Rulemaking published at 57 DC12222, 12223 (December 24, 2010)