1. A. The Commission shall maintain a prospective payment system based on diagnosis related groups with methodology and prices established by the Commission for the payment of inpatient hospital services.

   1. (1) Hospitals submit claims for payment to the employer or insurance carrier on the Form 14A.
   2. (2) The Commission recognizes the current uniform billing (UB) form as its Form 14A for hospitals.
   3. (3) The employer or insurance carrier reviewing the claim for payment shall be entitled to a copy of the applicable hospital records at no charge.
2. B. The Commission may review and revise the prospective payment system as needed.
3. C. An employer or insurance carrier may not pay, and a hospital may not accept, more than the amount set by the Commission for inpatient hospital services.

HISTORY: Added by State Register Volume 14, Issue No. 9, effective September 2, 1990. Amended by State Register Volume 17, Issue No. 4, eff April 23, 1993; State Register Volume 21, Issue No. 6, Part 2, eff June 27, 1997.