4809 TRANSFER CASES AND ABBREVIATED STAYS

4809.1 For each claim involving a transfer, the Department of Health Care Finance shall pay the transferring hospital the lesser of the APDRG amount or prorated payment based on the ratio of covered days to the average length of stay associated with the APDRG category. The prorated payment shall be calculated pursuant to the formula set forth in subsection 4808.5.

4809.2 The hospital from which the patient is ultimately discharged shall receive a payment equal to the total APDRG payment.

4809.3 All transfers, except for documented emergency cases shall be authorized and approved by the Department of Health Care Finance before the transfer as a condition of payment.

4809.4 Same day discharges shall not be paid as inpatient hospital stays unless the patient’s discharge status is death.

SOURCE: Final Rulemaking published at 45 DCR 4141, 4149 (June 26, 1998); as Final Rulemaking published at 49 DCR 8719 (September 20, 2002); as amended by Notice of Emergency and Proposed Rulemaking published at 57 DCR 2691 (March 26, 2010)[EXPIRED]; as amended by Notice of Emergency and Proposed Rulemaking published at 57 DCR 6837 (July 10, 2010)[EXPIRED]; as amended by Notice of Final Rulemaking published at 58 DCR 4323, 4330 (May 20, 2011).