256B.75 Hospital outpatient reimbursement. 

    (a) For outpatient hospital facility fee payments for 
 services rendered on or after October 1, 1992, the commissioner 
 of human services shall pay the lower of (1) submitted charge, 
 or (2) 32 percent above the rate in effect on June 30, 1992, 
 except for those services for which there is a federal maximum 
 allowable payment.  Effective for services rendered on or after 
 January 1, 2000, payment rates for nonsurgical outpatient 
 hospital facility fees and emergency room facility fees shall be 
 increased by eight percent over the rates in effect on December 
 31, 1999, except for those services for which there is a federal 
 maximum allowable payment.  Services for which there is a 
 federal maximum allowable payment shall be paid at the lower of 
 (1) submitted charge, or (2) the federal maximum allowable 
 payment.  Total aggregate payment for outpatient hospital 
 facility fee services shall not exceed the Medicare upper 
 limit.  If it is determined that a provision of this section 
 conflicts with existing or future requirements of the United 
 States government with respect to federal financial 
 participation in medical assistance, the federal requirements 
 prevail.  The commissioner may, in the aggregate, prospectively 
 reduce payment rates to avoid reduced federal financial 
 participation resulting from rates that are in excess of the 
 Medicare upper limitations. 

    (b) Notwithstanding paragraph (a), payment for outpatient, 
 emergency, and ambulatory surgery hospital facility fee services 
 for critical access hospitals designated under section 144.1483, 
 clause (11), shall be paid on a cost-based payment system that 
 is based on the cost-finding methods and allowable costs of the 
 Medicare program. 

    HIST: 1992 c 513 art 7 s 130; 1999 c 245 art 4 s 77