10A NCAC 22G .0106. RECONSIDERATION REVIEWS

(a)  As required by 42 CFR 447, Subpart C, providers may submit additional evidence for determination of reimbursement amounts pursuant to the Medicaid State Plan.  Providers may either accept agency reimbursement determinations or request a consideration review in accordance with the procedures set forth in 10A NCAC 22I and 22J.

(b)  Indirect rates shall not be adjusted on reconsideration review.

(c)  Direct rates may be adjusted for the following reasons:

(1)           to accommodate any changes in the minimum standards or minimum levels of resources required in the provision of patient care that are mandated by state or federal laws or regulation;

(2)           to correct any adjustments or revisions to ensure that the payment rate is calculated in accordance with Rule .0102 of this Section.

 

History Note:        Authority G.S. 108A‑25(b); 108A‑54; 108A‑55; S.L. 1985, c. 479, s. 86; 42 C.F.R. 447, Subpart C;

Eff. January 1, 1978;

Temporary Amendment Eff. October 1, 1984 for a Period of 120 Days to Expire on January 28, 1985;

Amended Eff. January 4, 1993; November 1, 1991; May 1, 1990; June 1, 1989;

Temporary Amendment Eff. August 3, 2004;

Amended Eff. February 1, 2005.