Tenn. Comp. R. & Regs. 1200-13-06-.14
Maximum Amount of Reimbursable Cost Payable to a Provider
Effective Oct 31, 1995Authority: T.C.A. §§4-5-202, 12-4-301, 71-5-105, and 71-5-109.Tennessee Department of Health, Tennessee Department of Environment and Conservation, and, Tennessee Department of Finance and Administration
(1) The maximum amount of reimbursable cost payable to a provider as provided for in these rules and regulations shall be the lesser of:
- (a) The usual and customary charges for comparable services of a particular provider; or
- (b) A maximum program-wide rate for Nursing facility Level I services as may be established by the Department in consultation with the Department of Finance and Administration; or
- (c) An allowable amount as determined by the Comptroller of the Treasury in accordance with the Department’s rules. In the event that an item is not addressed in the Department’s rules, Medicare principles of retrospective cost reimbursement shall apply.
Authority: T.C.A. §§4-5-202, 12-4-301, 71-5-105, and 71-5-109. Administrative History: Original rule filed January 12, 1988; effective February 26, 1988. Amendment filed august 17, 1995; effective October 31, 1995.