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April 2003# 03-3Kansas Medical Assistancessistance ProgramsHOSPITAL PROVIDERPolicy and Procedure UpdatePayment Rate RestoredBULLETINEffective with discharges on and after March 1, 2003 and with processing dates onand after March 10, 2003, the 10% reduction in the base DRG rates which wasimplemented on January 1, 2003 will be eliminated.DRG ADJUSTMENTSAttached are revised DRG rates and weights from the period Nov. 2, 2002 to thepresent. This includes changes for Jan. 1 and March 1, 2003 as well. These changes,originally proposed for Nov.1, 2002 were not approved by the Centers for Medicareand Medicaid Services (CMS). CMS would not approve the State plan because thepublic notice process, required in advance of a change, had not been followed.Claims for services on or after Nov. 2, 2002 will be reprocessed by the fiscal agent tore-determine the amounts that would be due in accordance with the previous weightsand rates that were in effect.The original date of the change was Nov. 1, 2002. However, in order to maintain atracking of the changes, the revised rates and weights will be retroactive to Nov. 2,2002. This means that discharges specifically on Nov. 1, 2002 will not be adjusted.This one day difference will also apply to the Jan. 1 and March 1 changes as well.Hospitals do not need to resubmit any claims.The reductions that were implemented on Jan. 1, 2003 did have the correct publicnotice and they are still implemented. However, the 10% cut in rates, as well as theother changes, must now be based upon the revised set of Nov. 2, 2002 rates andweights. This results in new weights and rates which are also attached for the morerecent time periods. The same applies for the March 1, 2003 changes.If you have any questions, please contact the Medicaid Customer Service Center at 1-800933-6593 (in-state providers) or (785) 274-5990 between 7:30 a.m. - 5:30 p.m., Mondaythrough Friday.Bulletins and manuals constitute proof of notification of program changes to KansasMedical Assistance providers. Please read these publications carefully and keep themfor future reference.is the fiscal agent and administrator of the Kansas Medical Assistance Program for theKansas Department of Social and Rehabilitation Services
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Hospital Rates Effective 11/01/2002ProviderNumberCost toCharge RatioHospitalPeer Group 186297501 Kansas City - Bethany Medical Center30073401 Kansas City - Providence Medical Center85590401 Kansas City - Select Specialty30091401 Lawrence Memorial Hospital30119501 Olathe Community Hospital11769602 Overland Park - Children's Mercy South34506301 Overland Park - Menorah Medical Par39900201 Overland Park - Mid-America Rehab86349801 Overland Park - St. Lukes South86996602 Overland Park - Specialty Hospital of Mid America86685801 Overland Park Regional Med Ctr26592601 Shawnee Mission Medical Center10623601 Topeka - Menninger Clinic17661201 Topeka - Saint Francis Hospital86060001 Topeka - Select Specialty30152201 Topeka - Stormont Vail Hospital39900601 Topeka- Kansas Rehabilitation Hospital86744701 Wichita - Kansas Heart Hospital85898501 Wichita - Kansas Surgery & Recovery Cent30162301 Wichita - Riverside Hospital86996601 Wichita Specialty Hospital18539001 Wichita - Via Christi- Regional Med18539002 Wichita - Via Christi- Regional Med34512301 Wichita - Via Christi Rehab ( Our Lady O86295101 Wichita - Wesley39900001 Wichita- Wesley Rehabilitation HospitalDefault CCRAverage Peer Group 3,027
Hospital Rates Effective 1/1/2003ProviderNumberCost toCharge RatioHospitalPeer Group 186297501 Kansas City - Bethany Medical Center30073401 Kansas City - Providence Medical Center85590401 Kansas City - Select Specialty30091401 Lawrence Memorial Hospital30119501 Olathe Community Hospital11769602 Overland Park - Children's Mercy South34506301 Overland Park - Menorah Medical Par39900201 Overland Park - Mid-America Rehab86349801 Overland Park - St. Lukes South86996602 Overland Park - Specialty Hospital of Mid America86685801 Overland Park Regional Med Ctr26592601 Shawnee Mission Medical Center10623601 Topeka - Menninger Clinic17661201 Topeka - Saint Francis Hospital86060001 Topeka - Select Specialty30152201 Topeka - Stormont Vail Hospital39900601 Topeka- Kansas Rehabilitation Hospital86744701 Wichita - Kansas Heart Hospital85898501 Wichita - Kansas Surgery & Recovery Cent30162301 Wichita - Riverside Hospital86996601 Wichita Specialty Hospital18539001 Wichita - Via Christi- Regional Med18539002 Wichita - Via Christi- Regional Med34512301 Wichita - Via Christi Rehab ( Our Lady O86295101 Wichita - Wesley39900001 Wichita- Wesley Rehabilitation HospitalDefault CCRAverage Peer Group 2,724
Hospital Rates Effective 3/1/2003ProviderNumberCost toCharge RatioHospitalPeer Group 186297501 Kansas City - Bethany Medical Cente30073401 Kansas City - Providence Medical Center85590401 Kansas City - Select Specialty30091401 Lawrence Memorial Hospital30119501 Olathe Community Hospital11769602 Overland Park - Children's Mercy South34506301 Overland Park - Menorah Medical Par39900201 Overland Park - Mid-America Rehab86349801 Overland Park - St. Lukes South86996602 Overland Park - Specialty Hospital of Mid America86685801 Overland Park Regional Med Ctr26592601 Shawnee Mission Medical Center10623601 Topeka - Menninger Clinic17661201 Topeka - Saint Francis Hospital86060001 Topeka - Select Specialty30152201 Topeka - Stormont Vail Hospital39900601 Topeka- Kansas Rehabilitation Hospital86744701 Wichita - Kansas Heart Hospital85898501 Wichita - Kansas Surgery & Recovery Cent30162301 Wichita - Riverside Hospital86996601 Wichita Specialty Hospital18539001 Wichita - Via Christi- Regional Med18539002 Wichita - Via Christi- Regional Med34512301 Wichita - Via Christi Rehab ( Our Lady O86295101 Wichita - Wesley39900001 Wichita- Wesley Rehabilitation HospitalDefault CCRAverage Peer Group 3,027
Kansas 2003 DRG Weights and LimitsEffective 26421417377CostOutlierAdj. 153,642CostOutlierAdj. 575757575757575757575757575
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75757575757575757575757575
757575757575757575
7575757575757575757575757575
757575757575757575757575757575757575757575
1,4961,5051,9201,5471,6281,4721,668688- 10 757575
8541,3771,5091,3471,3391,3111,3561,378- 11 75757575757575757575757575757575
801,0398821,7701,2671,7551,0561,0111,5251,683- 12 5757575757575757575
1,2531,0951,139- 13 5757575757575757575757575757575757575
51,3721,7923,4382,4431,9912,074- 14 48382931
34506301 Overland Park - Menorah Medical Par 0.4042 3,027 39900201 Overland Park - Mid-America Rehab 0.4204 3,027 86349801 Overland Park - St. Lukes South 0.4875 3,027 86996602 Overland Park - Specialty Hospital of Mid Ameri
