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reallocate the proportionate share eligibility and payments for all hospitals and will recoup payments from all hospitals on a prorated basis if the

(A) proportionate share eligibility and payment for any private hospital will be recalculated as a result of a decision under (10) or (11) of this subsection or of a court decision; or

(B) outcome of a decision under (10) or (11) of this subsection or of a court decision would cause the total private hospital proportionate share payments to exceed the federal allotment for the federal fiscal year in which the payment rate was in effect. (b) In this section, unless the context requires otherwise,

(1) “encounter” means a unit of service, visit, or face-to-face contact that is a covered service under an agreement with the department as required under this section;

(2) “payment year” means the state fiscal year;

(3) “qualification date” means July 1 of each year;

(4) “qualifying hospital” means a hospital that qualifies under (a)(1) of this subsection for a private hospital proportionate share payment;

(5) “qualifying year” means the hospital’s most recent fiscal year that the department determines complete. (Eff. 2/1/2010, Register 193) Statutory Authority: Authority: AS 47.05.010 AS 47.07.040

AS 47.07.030 AS 47.07.070 7 AAC 150.120. Methodology and criteria for proportionate share payments to state-owned or state-operated hospitals. (a) To implement the provisions of 42 U.S.C. 1396b regarding federal financial participation under Medicaid, and subject to legislative appropriations for that purpose, the department will make a state hospital proportionate share payment to, and may require specific services to be performed by, a hospital that qualifies under (1) of this subsection in order to ensure continued access to inpatient and outpatient hospital services or other health services, and in order to secure for the state in accordance with AS 47.07.040, the optimum federal participation for inpatient