No, facilities that are licensed, covered, and paid under the Medicaid state plan as inpatient hospital or nursing facilities should be included in the UPL calculated for those services. There is no regulatory requirement to conduct separate calculations for designated facility "types" within each of the applicable service categories. States do not need to provide separate UPL demonstrations for IMDs covered under the inpatient hospital or nursing facility services benefit.
Date
Sub Topic
FAQ ID
92381
FAQ Page
FAQ Question
Our state covered institutions for mental disease (IMD) under the inpatient hospital and nursing benefit. Should we conduct a separate UPL for these facilities?