C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—MEDICARE PROGRAM › PART 412—PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES › Subpart K—Prospective Payment System for Inpatient Operating Costs for Hospitals Located in Puerto Rico

42 C.F.R. § 412.200

General provisions

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Beginning with discharges occurring on or after October 1, 1987, hospitals located in Puerto Rico are subject to the rules governing the prospective payment system for inpatient operating costs. Except as provided in this subpart, the provisions of subparts A, B, C, F, G, and H of this part apply to hospitals located in Puerto Rico. Except for § 412.60, which deals with DRG classification and weighting factors, or as otherwise specified, the provisions of subparts D and E, which describe the methodology used to determine prospective payment rates for inpatient operating costs for hospitals, do not apply to hospitals located in Puerto Rico. Instead, the methodology for determining prospective payment rates for inpatient operating costs for these hospitals is set forth in §§ 412.204 through 412.212.

[83 FR 41704, Aug. 17 2018]
Notes of Decisions
Cited in 1 case, 1990–1990 · leading case: Hosp. de Area de Carolina v. Sullivan, 735 F. Supp. 432 (D.D.C. 1990).
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Hosp. de Area de Carolina v. Sullivan, 735 F. Supp. 432 (D.D.C. 1990). “A new system for payment of certain operating costs on a "prospective rate" basis of payment was established under 42 C.F.R. § 412.200 and became applicable to the Hospital in 1987.”
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