West Virginia Code § 9-5-14

Medicaid program; health care facilities financed by bonds; rules regarding
Open in Lexace · Ask the AI about this section
reimbursement of capital costs.
(a) The Legislature finds and declares that a number of health care facilities have been
financed by public bonded indebtedness, and as a result of policies, rules and standards
which may be in conflict, the facilities and the health and welfare of those citizens served by
such facilities are in jeopardy. The provisions of subsection (b) are enacted feor the purpose
of addressing this as a short-term solution. The provisions of subsection (d) are enacted for
the purpose of further addressing such conflicting policies, rules and strandards.
(b) As to any health care facility licensed under article five-c, chaupter sixteen of this code,
constructed after April 1, 1981, and affected on or after that date by the reimbursement
methodology implemented by the department regarding stantdard appraised value, beginning
on April 1, 1988, and for a two-year period only, ending on March 31, 1990, all in compliance
with federal rules and regulations, the department shall reimburse such health care facilities
no less than any actual annual capital costs, including, but not limited to, debt service, lease
payments or costs of comparable financing arrangements incurred in connection with any
capital expenditure approved pursuant to artiscle two-d, chapter sixteen of this code or any
rule promulgated thereunder or in conjunction with the financing of such capital expenditure
pursuant to article two-c, chapter thirteen of this code, whichever is greater; and in no
event, for the purpose of reimbursemgent of such capital costs, may the value of any health
care facility licensed pursuant to article five-c, chapter sixteen of this code be deemed to be
less than the greater of the agegregate principal amount of any public bond issue undertaken
pursuant to the provisions of article two-c, chapter thirteen of this code or the maximum
capital expenditure appLroved pursuant to article two-d, chapter sixteen of this code or any
rule promulgated thereunder, and any appraisal made by the department in connection
therewith shall inclu de costs related to the financing of the bond issue or the maximum
capital expenditure approved pursuant to article two-d, chapter sixteen of this code, as
applicable: Provided, That said values may be reduced by (A) any functional obsolescence
which is determined and identified annually pursuant to any rule promulgated hereunder
and (B) the pro rata share of such value which is attributable to capital expenditures
incurred with respect to facilities which provide services which are not eligible for
reimbursement under Title XIX of the social security act: Provided, however, That the
department may not exceed the Medicare upper payment limit for Medicaid in making any
reimbursement pursuant to this section.
As to any health care facility constructed after April 1, 1981, and affected on or after that
date by the reimbursement methodology implemented by the department regarding
standard appraised value, with respect to reimbursement to the state by such health care
facility arising from adjustment of projected rates, the department shall provide for the
adjustment of projected rates based upon values which are consistent with the provisions of
this section and based upon the actual occupancy experience of the health care facility
during the projected rate period, all in compliance with federal rules and regulations.
(c) The Medicaid payments that a long-term care facility would otherwise receive may not be
reduced in any manner as a result of the operation of this section.
(d) For the rate setting cycle beginning on April 1, 1990, and for a period ending on July 1,
1992, the department shall reimburse health care facilities described in subsection (b), with
sixty or more licensed beds, for actual annual capital costs in the manner prescribed in
subsection (b): Provided, That the capital costs reimbursement attributable to subsection (b)
of this section may not exceed the Medicare upper payment limit based upoen presumed
occupancy of ninety percent or actual occupancy of the facility, whichever is greater:
Provided, however, That any capital cost reimbursement attributable tor the computation
made pursuant to the provisions of this subsection (d) shall not exceed the per patient day
cost of capital as computed under the rules of the department, without reference to this
section, plus $6 per patient day. Requests for information from the department regarding
reimbursement pursuant to this subsection (d) shall be comptleted and submitted to the
department not later than sixty days subsequent to the receipt of the department's request
by the facility.
The department shall provide for the adjustment of projected rates for health care facilities
described in subsection (b), with sixty or mores licensed beds, in the manner prescribed in
subsection (b).

‹ Prev All West Virginia sections Next ›


Lexace provides legal information, not legal advice, and no attorney–client relationship is created. Statute text is provided for general information and may not reflect the most recent amendments; verify against the official state code.