Laws: Cases and Codes : U.S. Code : Title 42 : Section 1396l


   
U.S. Code as of: 01/19/04
Section 1396l. Hospital providers of nursing facility services

      (a) Notwithstanding any other provision of this subchapter,
    payment may be made, in accordance with this section, under a State
    plan approved under this subchapter for nursing facility services
    furnished by a hospital which has in effect an agreement under
    section 1395tt of this title and which, with respect to the
    provision of such services, meets the requirements of subsections
    (b) through (d) of section 1396r of this title.
      (b)(1) Except as provided in paragraph (3), payment to any such
    hospital, for any nursing facility services furnished pursuant to
    subsection (a) of this section, shall be at a rate equal to the
    average rate per patient-day paid for routine services during the
    previous calendar year under the State plan to nursing facilities,
    respectively,)1(! located in the State in which the hospital is
    located. The reasonable cost of ancillary services shall be
    determined in the same manner as the reasonable cost of ancillary
    services provided for inpatient hospital services.

      (2) With respect to any period for which a hospital has an
    agreement under section 1395tt of this title, in order to allocate
    routine costs between hospital and long-term care services, the
    total reimbursement for routine services due from all classes of
    long-term care patients (including subchapter XVIII of this
    chapter, this subchapter, and private pay patients) shall be
    subtracted from the hospital total routine costs before
    calculations are made to determine reimbursement for routine
    hospital services under the State plan.
      (3) Payment to all such hospitals, for any nursing facility
    services furnished pursuant to subsection (a) of this section, may
    be made at a payment rate established by the State in accordance
    with the requirements of section 1396a(a)(13)(A) of this title.



Previous [Notes] Next

Related Resources

Health Law Guide

Health Articles and Documents

Health Discussion

Ads by FindLaw