- (1) "Directed payment" means a payment arrangement authorized by CMS that permits the department to direct specific payments made by a managed care plan to providers.
- (2) "Improvement margin" means a percentage determined by the department after consulting with hospitals and in accordance with evidence-based guidelines and national benchmarks.
- (3) "Rural hospital" means a general acute hospital in a rural setting, except for a specialty hospital.
- (4) "Specialty hospital" means a specialty hospital in an urban or rural setting as defined in Section 26B-3-701.
- (5) "Urban hospital" means a diagnosis-related group (DRG)-reimbursed hospital in an urban setting, except for a specialty hospital.
For purposes of this rule, the following definitions apply.
KEY: Medicaid
Date of Last Change: June 24, 2024
Authorizing, and Implemented or Interpreted Law: 26B-1-213; 26B-3-108