§412.212. National rate.
42 C.F.R. § 412.212
General rule. For purposes of payment to hospitals located in Puerto Rico, the national prospective payment rate for inpatient operating costs is determined as described in paragraphs (b) through (d) of this section.
Computing Puerto Rico standardized amounts.
For Federal fiscal years before FY 2004, CMS computes a discharge-weighted average of the—
National urban adjusted standardized amount determined under § 412.63(j)(1); and
National rural adjusted average standardized amount determined under § 412.63(j)(2)(i).
For fiscal years 2004 and subsequent fiscal years, CMS computes a discharge-weighted average of the national adjusted standardized amount determined under § 412.64(e).
Computing a national rate. For each discharge classified within a DRG, the national rate equals the product of—
The national average standardized amount computed under paragraph (b) of this section; and
The weighting factor (determined under § 412.60(b)) for that DRG.
Adjusting for different area wage levels. CMS adjusts the proportion (as estimated by CMS from time to time) of the national rate computed under paragraph (c) of this section that is attributable to wages and labor-related costs for area differences in hospital wage levels by a factor (established by CMS) reflecting the relative hospital wage level in the geographic area of the hospital compared to the national average hospital wage level.
Notes, amendments, and revision history
Amendments
[52 FR 33058, Sept. 1, 1987, as amended at 53 FR 38533, Sept. 30, 1988; 57 FR 39825, Sept. 1, 1992; 69 FR 49248, Aug. 11, 2004]
Source
Source: 52 FR 33058, Sept. 1, 1987, unless otherwise noted.
Authority
Authority: 42 U.S.C. 1302 and 1395hh.
Source
Source: 50 FR 12741, Mar. 29, 1985, unless otherwise noted.
Amendments
[52 FR 33058, Sept. 1, 1987, as amended at 53 FR 38533, Sept. 30, 1988; 57 FR 39825, Sept. 1, 1992; 69 FR 49248, Aug. 11, 2004]