<html> <head> <title>Rule 67:16:03:06.02 Certain in-state hospitals, hospital units, and procedures exempt from DRG basis of reimbursement.</title> <META NAME="Keywords" Content="Administrative Rules 67:16:03:06.02"> <META NAME="Description" Content="Administrative Rules 67:16:03:06.02 Certain in-state hospitals, hospital units, and procedures exempt from DRG basis of reimbursement."> <meta name=Generator content="Microsoft Office HTML Filter 2.0"> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Originator content="Microsoft Word 10"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>67:16:03:06.02.&nbsp;&nbsp;Certain in-state hospitals, hospital units, and procedures exempt from DRG basis of reimbursement.</b> In-state freestanding rehabilitation hospitals, public health service hospitals, acute care hospitals with less than 30 Medicaid discharges during their fiscal year ending after June 30, 1996, and before July 1, 1997, and the South Dakota Children's Care Hospital are exempt from DRG reimbursement provisions. The department may exempt in-state intensive care nursery units from DRG reimbursements on request by the hospital if all costs and statistics relating to the operation of the unit are identifiable and if the unit meets the following criteria:</font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (1)&nbsp;&nbsp;Can provide care for infants under 750 grams;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (2)&nbsp;&nbsp;Can provide care for infants on ventilators;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (3)&nbsp;&nbsp;Can provide major surgery for newborns;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (4)&nbsp;&nbsp;Has 24-hour coverage by a neonatologist; and</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (5)&nbsp;&nbsp;Has a maternal neonatology transport team.</font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The department may exempt a psychiatric unit and a rehabilitation unit from DRG reimbursements on request by the hospital if all costs and statistics relating to the operation of the particular unit are identifiable.</font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> Transferred from §&nbsp;67:16:03:06, 13 SDR 8, effective August 3, 1986; 15 SDR 2, effective July 17, 1988; 15 SDR 167, effective May 11, 1989; 16 SDR 239, effective July 9, 1990; 17 SDR 180, effective May 27, 1991; 17 SDR 200, effective July 1, 1991: 22 SDR 143, effective May 9, 1996; 25 SDR 116, effective March 24, 1999.</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-1">28-6-1.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-1">28-6-1.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Cross-Reference:</b> Reimbursement for DRG-exempt hospitals and units, §&nbsp;67:16:03:06.06.</font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html>