900 KAR 7:030. Data reporting by health care providers

Link to law: http://www.lrc.ky.gov/kar/900/007/030reg.htm
Published: 2015

CABINET FOR HEALTH AND FAMILY

SERVICES

Office of Health Policy

(Amendment)

 

      900

KAR 7:030. Data reporting by health care providers.

 

      RELATES

TO: KRS Chapter 13B, 216.2920-216.2929

      STATUTORY

AUTHORITY: KRS 216.2923(3), 216.2925

      NECESSITY,

FUNCTION, AND CONFORMITY: KRS 216.2925 requires that the Cabinet for Health and

Family Services promulgate administrative regulations requiring specified

health care providers to provide the cabinet with data on cost, quality, and

outcomes of health care services provided in the Commonwealth. KRS 216.2923(3)

authorizes the cabinet to promulgate administrative regulations to impose fines

for failure to report required data. This administrative regulation establishes

the required data elements, forms, and timetables for submission of data to the

cabinet and fines for noncompliance.

 

      Section

1. Definitions. (1) "Agent" means any entity with which the cabinet

may contract to carry out its statutory mandates, and which it may designate to

act on behalf of the cabinet to collect, edit, or analyze data from providers.

      (2)

"Ambulatory facility" is defined by KRS 216.2920(1).

      (3)

"Cabinet" is defined by KRS 216.2920(2).

      (4)

"Coding and transmission specifications", "Kentucky Inpatient

and Outpatient Data Coordinator's Manual for Hospitals", or "Kentucky

Data Coordinator's Manual for Ambulatory Facilities" means the document

containing the technical directives the cabinet issues concerning technical

matters subject to frequent change, including codes and data for uniform

provider entry into particular character positions and fields of the standard

billing form and uniform provider formatting of fields and character positions

for purposes of electronic data transmissions.

      (5)

"Hospital" is defined by KRS 216.2920(6).

      (6)

"Hospitalization" means the inpatient medical episode identified by a

patient's admission date, length of stay, and discharge date, that is

identified by a provider-assigned patient control number unique to that

inpatient episode, except for:

      (a)

Inpatient services a hospital may provide in swing, nursing facility, skilled, intermediate

or personal care beds; or

      (b)

Hospice care.

      (7)

"National Provider Identifier" or "NPI" means the unique

identifier assigned by the Centers for Medicare and Medicaid Services to an

individual or entity that provides health care services and supplies.

      (8)

"Outpatient services" means services performed on an outpatient basis

in a hospital in accordance with Section 3(2) of this administrative regulation

or services performed on an outpatient basis by an ambulatory facility in

accordance with Section 4 of this administrative regulation.

      (9)

"Provider" means a hospital, ambulatory facility, clinic, or other

entity of any nature providing hospitalizations, mammograms, or outpatient services

as defined in the Kentucky Inpatient and Outpatient Data Coordinator's Manual

for Hospitals or the Kentucky Data Coordinator's Manual for Ambulatory

Facilities.

      (10)

"Record" means the documentation of a hospitalization or outpatient

service in the format prescribed by the Kentucky Inpatient and Outpatient Data

Coordinator's Manual for Hospitals or the Kentucky Data Coordinator's Manual

for Ambulatory Facilities as approved by the Statewide Data Advisory Committee

on a computer readable electronic medium.

      (11)

"Standard Billing Form" means the uniform health insurance claim form

pursuant to KRS 304.14-135, the Professional 837 (ASC X12N 837) format, the

Institutional 837 (ASC X12N 837) format, or its successor as adopted by the

Centers for Medicare and Medicaid Services, or the HCFA 1500 for use by

hospitals and other providers in billing for hospitalizations and outpatient

services.

 

      Section

2. Medicare Provider-Based Entity. A licensed outpatient facility that is a

Medicare provider-based entity of a hospital and reports under the hospital's

provider number shall be separately identifiable through a facility-specific

NPI.

 

      Section

3. Data Collection for Hospitals. (1) Inpatient hospitalization records. A

hospital shall document every hospitalization it provides on a Standard Billing

Form and shall, from every record, copy and provide to the cabinet the data

specified in Section 12 of this administrative regulation.

      (2)

Outpatient services records.

      (a)

A hospital shall document on a Standard Billing Form the outpatient services it

provides and shall from every record, copy and provide to the cabinet the data

specified in Section 12 of this administrative regulation.

      (b)

A hospital shall submit records that contain the required outpatient services procedure

codes specified in the Kentucky Inpatient and Outpatient Data Coordinator's

Manual for Hospitals.

      (3)

Data collection on patients. A hospital shall submit required data on every

patient as provided in Section 12 of this administrative regulation, regardless

of the patient’s billing or payment status.

 

      Section

4. Data Collection for Ambulatory Facilities. (1) Outpatient services records.

      (a)

An ambulatory facility shall document on a Standard Billing Form the outpatient

services it provides and shall, for every record, copy and provide to the

cabinet the data specified in Section 13 of this administrative regulation.

      (b)

An ambulatory facility shall submit records that contain the required

outpatient services procedure codes specified in the Kentucky Data

Coordinator's Manual for Ambulatory Facilities.

      (2)

Data collection on patients. An ambulatory facility shall submit required data

on every patient as provided in Section 13 of this administrative regulation,

regardless of the patient’s billing or payment status.

 

      Section

5. Data Finalization and Submission by Providers. (1) Submission of final data.

      (a)

Data shall be final for purposes of submission to the cabinet as soon as a

record is sufficiently final that the provider could submit it to a payer[payor]

for billing purposes, regardless of whether the record has actually been

submitted to a payer[payor].

      (b)

Finalized data shall not be withheld from submission to the cabinet on grounds

that it remains subject to adjudication by a payer[payor].

      (c)

Data on a hospitalization shall not be submitted to the cabinet before a

patient is discharged and before the record is sufficiently final that it could

be used for billing.

      (2)

Data submission responsibility.

      (a)

If a patient is served by a mobile health service, specialized medical

technology service, or another situation where one (1) provider provides

services under contract or other arrangement with another provider,

responsibility for providing the specified data to the cabinet shall reside

with the provider that bills for the service or would do so if a service is

unbilled.

      (b)

Charges for physician services provided within a hospital shall be reported to

the cabinet.

      1.

Responsibility for reporting the physician charge data shall rest with the

hospital if the physician is an employee of the hospital.

      2.

A physician charge contained within a record generated by a hospital shall be

clearly identified in a separate field within the record so that the cabinet

may ensure comparability when aggregating data with other hospital records that

do not contain physician charges.

      (3)

Transmission of records.

      (a)

Records submitted to the cabinet by a hospital shall be uniformly completed and

formatted according to coding and transmission specifications set forth by the

Kentucky Inpatient and Outpatient Data Coordinator's Manual for Hospitals.

      (b)

Records submitted to the cabinet by an ambulatory facility shall be uniformly

completed and formatted according to coding and transmission specifications set

forth by the Kentucky Data Coordinator's Manual for Ambulatory Facilities.

      (c)

Each provider shall submit data by electronic transmission as specified by the

Kentucky Inpatient and Outpatient Data Coordinator’s Manual for Hospitals and

the Kentucky Data Coordinator’s Manual for Ambulatory Facilities.

      (d)

Each provider shall provide back-up security against accidental erasure or loss

of the data until all incomplete or inaccurate records identified by the

cabinet have been corrected and resubmitted.

      (4)

Verification and audit trail for electronic data submissions.

      (a)

Each provider shall maintain a date log of data submissions and the number of

records contained in each submission, and shall make the log available for

inspection upon request by the cabinet.

      (b)

The cabinet shall, within twenty-four (24) hours of submission, verify by

electronic message to each provider the receipt of the provider's data

transmissions and the number of records in each transmission.

      (c)

A provider shall immediately notify the cabinet of a discrepancy between the

provider's date log and a verification notice.

 

      Section

6. Data Submission Timetable for Providers. (1) Quarterly submissions. Each

provider shall submit data at least once for each calendar quarter. A quarterly

submission shall:

      (a)

Contain data, which during that quarter became final as specified in Section

5(1) of this administrative regulation; and

      (b)

Be submitted to the cabinet not later than forty-five (45) days after the last

day of the quarter.

      1.

If the 45th day falls on a weekend or holiday, the submission due date shall be

the next working day.

      2.

Calendar quarters shall be January 1 through March 31, April 1 through June 30,

July 1 through September 30, and October 1 through December 31.

      (2)

Submissions more frequent than quarterly. A provider may submit data after

records become final as specified in Section 5(1) of this administrative

regulation and at a reasonable frequency convenient to a provider for

accumulating and submitting batch data.

 

      Section

7. Data Corrections for Providers. (1) Editing. Data received by the cabinet

shall, upon receipt, be edited to ensure completeness and validity of the data.

Computer editing routines shall identify for correction every record in which

the submitted contents of required fields are not consistent with the cabinet’s

coding and transmission specifications contained in the Kentucky Inpatient and

Outpatient Data Coordinator's Manual for Hospitals and the Kentucky Data

Coordinator’s Manual for Ambulatory Facilities.

      (2)

Submission of corrections. The cabinet shall allow a provider thirty (30) days

in which to submit corrected copies of initially submitted data the cabinet

identifies as incomplete or invalid as a result of edits.

      (a)

The thirty (30) days shall begin on the date of the cabinet's notice informing

the provider that corrections are required.

      (b)

A provider shall submit to the cabinet corrected data by electronic

transmission within thirty (30) days.

      (c)

Corrected data submitted to the cabinet shall be uniformly completed and

formatted according to the cabinet's coding and transmission specifications

contained in the Kentucky Inpatient and Outpatient Data Coordinator's Manual

for Hospitals and the Kentucky Data Coordinator’s Manual for Ambulatory

Facilities.

      (3)

Percentage error rate.

      (a)

When editing data upon its initial submission, the cabinet shall identify and

return to the provider for correction every record in which one (1) or more of

the required data elements fails to pass the edit.

      (b)

When editing data that a provider has submitted, the cabinet shall check for an

error rate per quarter of no more than one (1) percent of records or not more

than ten (10) records, whichever is greater.

      (c)

The cabinet may return for further correction any submission of allegedly

corrected data in which the provider fails to achieve a corrected error rate

per quarter of no more than one (1) percent of records or not more than ten

(10) records, whichever is greater.

 

      Section

8. Fines for Noncompliance for Providers. (1) A provider failing to meet

quarterly submission guidelines as established in Sections 6 and 7 of this

administrative regulation shall be assessed a fine of $500 per violation.

      (2)

The cabinet shall notify a noncompliant provider by certified mail, return

receipt requested, of the documentation of the reporting deficiency and the

assessment of the fine.

      (3)

A provider shall have thirty (30) days from the date of receipt of the

notification letter to pay the fine which shall be made payable to the Kentucky

State Treasurer and sent by certified mail to the Kentucky Cabinet for Health

and Family Services, Office of Health Policy, 275 East Main Street 4 W-E,

Frankfort, Kentucky, 40621.

      (4)

Fines during a calendar year shall not exceed $1,500 per provider.

 

      Section

9. Extension or Waiver of Data Submission Timelines. (1) A provider experiencing

extenuating circumstances or a hardship may request from the cabinet, in

writing, a data submission extension or waiver.

      (a)

A provider shall request an extension or waiver from the Office of Health

Policy on or before the last day of the data reporting period to receive an

extension or waiver for that period.

      (b)

An extension or waiver shall not exceed a continuous period of greater than six

(6) months.

      (2)

The cabinet shall consider the following criteria in determining whether to

grant an extension or waiver:

      (a)

Whether the request was made due to an event beyond the provider's control,

such as a natural disaster, catastrophic event, or theft of necessary equipment

or information;

      (b)

The severity of the event prompting the request; and

      (c)

Whether the provider continues to gather and submit the information necessary

for billing.

      (3)

A provider shall not apply for more than three (3) extensions or waivers during

a calendar year.

 

      Section

10. Appeals for Providers. (1) A provider notified of its noncompliance and

assessed a fine pursuant to Section 8(1) of this administrative regulation

shall have the right to appeal within thirty (30) days of the date of the

notification letter.

      (a)

If the provider believes the action by the cabinet is unfair, without reason,

or unwarranted, and the provider wishes to appeal, it shall appeal in writing

to the Secretary of the Cabinet for Health and Family Services, 5th Floor, 275

East Main Street, Frankfort, Kentucky, 40621.

      (b)

An appeal shall be filed in accordance with KRS Chapter 13B.

      (2)

Upon receipt of the appeal, the secretary or designee shall issue a notice of

hearing no later than twenty (20) days before the date of the hearing. The

notice of the hearing shall comply with KRS 13B.050. The secretary shall

appoint a hearing officer to conduct the hearing in accordance with KRS Chapter

13B.

      (3)

The hearing officer shall issue a recommendation in accordance with KRS

13B.110. Upon receipt of the recommended order, following consideration of any

exceptions filed pursuant to KRS 13B.110(4), the secretary shall enter a final

decision pursuant to KRS 13B.120.

 

      Section

11. Working Contacts for Providers. (1) On or before the last day of the data

reporting period, a provider shall report by electronic transmission to the

cabinet the names and telephone numbers of a designated contact person and one

(1) back-up person to facilitate technical follow-up in data reporting and

submission.

      (a)

A provider's designated contact and back-up shall not be the chief executive

officer unless no other person employed by the provider has the requisite

technical expertise.

      (b)

The designated contact shall be the person responsible for review of the

provider's data for accuracy prior to the publication by the cabinet.

      (2)

If the chief executive officer, designated contact person, or back-up person

changes during the year, the name and telephone number of the replacing person

shall be reported immediately to the cabinet.

 

      Section

12. Required Data Elements for Hospitals. (1) A hospital shall ensure that each

record submitted to the cabinet contains at least the data elements identified

in this section and as provided on the Standard Billing Form.

      (2)

A single asterisk identifies elements that shall not be blank and shall contain

data or a code as specified in the cabinet's coding and transmission

specifications contained in the Kentucky Inpatient and Outpatient Data

Coordinator's Manual for Hospitals.

      (3)

Double asterisks identify elements that shall not be blank if present on the

record and shall contain data or a code as specified in the cabinet’s coding

and transmission specifications contained in the Kentucky Inpatient and Outpatient

Data Coordinator’s Manual for Hospitals.

      (4)

Additional data elements, as specified in the Kentucky Inpatient and Outpatient

Data Coordinator's Manual for Hospitals, shall be required by the cabinet to

facilitate proper collection and identification of data.



Required





DATA

ELEMENT LABEL







Yes





*Provider

Assigned Patient Control Number







Yes





**Provider

Assigned Medical Record Number







Yes





*Type

of Bill (inpatient, outpatient or other)







Yes





**Federal

Tax Number or Employer Identification Number (EIN)







Yes





*Facility-specific

NPI







Yes





*Statement

Covers Period







Yes





*Patient

City and Zip Code







Yes





*Patient

Birth date







Yes





*Patient

Sex







Yes





*Admission/Start

of Care Date







Yes





**Admission

Hour







Yes





*Type

of Admission







Yes





*Source

of Admission







Yes





*Patient

Status (at end of service or discharge)







No





Occurrence

Codes & Dates







Yes





**Value

Codes and Amounts, including birth weight in grams







Yes





*Revenue

Codes/Groups







Yes





*HCPCS/Rates/Hipps

Rate Codes







Yes





*Units

of Service







Yes





*Total

Charges by Revenue Code Category







Yes





*Payer

[Payor] Identification – Payer [Payor] Name







Yes





*National

Provider Identifier







Yes





*Diagnosis

Version Qualifier - ICD version 9.0 or 10.0







Yes





*Principal

Diagnosis Code







Yes





*Principal

Diagnosis Code present on admission identifier for non-Medicare claims







Yes





*Principal

Diagnosis Code present on admission identifier for Medicare claims







Yes





**Secondary

and Other Diagnosis Codes







Yes





**Secondary

and Other Diagnosis code present on admission identifier for non-Medicare

claims

 







Yes





**Secondary

and Other Diagnosis code present on admission identifier for Medicare claims







Yes





*Inpatient

Admitting Diagnosis







Yes





**Outpatient

reason for visit







Yes





*External

Cause of Injury Code (E-code) if present







Yes





*External

Cause of Injury (E-code) present on admission identifier on non-Medicare

claims if present







Yes





*External

Cause of Injury (E-code) present on admission identifier on Medicare claims

if present







Yes





*Principal

Procedure Code & Date if present







Yes





**Secondary

and Other Procedure Codes & Date if present







Yes





*Attending

Physician NPI/QUAL/ID







Yes





*Operating

Clinician ID Number/NPI







Yes





**Other

Physician NPI/QUAL/ID







Yes





*Race







Yes





*Ethnicity





 

      Section

13. Required Data Elements for Ambulatory Facilities.(1) An ambulatory facility

shall ensure that each record submitted to the cabinet contains at least the

data elements identified in this section and as provided on the Standard

Billing Form.

      (2)

A single asterisk identifies elements that shall not be blank and shall contain

data or a code as specified in the cabinet's coding and transmission

specifications contained in the Kentucky Data Coordinator's Manual for

Ambulatory Facilities.

      (3)

Double asterisks identify elements that shall not be blank if present on the

record and shall contain data or a code as specified in the cabinet’s coding

and transmission specifications contained in the Kentucky Data Coordinator’s

Manual for Ambulatory Facilities.

      (4)

Additional data elements, as specified in the Kentucky Data Coordinator's

Manual for Ambulatory Facilities, shall be required by the cabinet to

facilitate proper collection and identification of data.



Required





DATA

ELEMENT LABEL







Yes





*Patient

Birth date







Yes





*Patient

Sex







Yes





*Zip

Code







Yes





*1st

Individual Payer ID#







Yes





*Admission/Start

of Care Date







Yes





*Type

of Bill







Yes





*Principal

Diagnosis Code







Yes





**Secondary

and Other Diagnosis Codes if present







Yes





*Principal

Procedure Code & Date







Yes





**Secondary

and Other Procedure Codes & Date if present







Yes





*1st

Units of Service







Yes





*1st

Charge







Yes





**Secondary

and Other Units of Service and Charge







Yes





*Total

Charges for the Case







Yes





*Attending

Clinician NPI







Yes





*Provider

Assigned Patient ID#







Yes





**1st

Insurer Group #







Yes





**2nd

Insurer Group #







Yes





*Operating

Clinician NPI







Yes





*Billing

Facility-specific NPI







Yes





**Federal

Tax Number or Employer Identification Number (EIN)







Yes





*Statement

Covers Period







Yes





*Primary

Payer [Payor] Name







Yes





**Secondary

Payer [Payor] Name







Yes





*Race







Yes





*Ethnicity







Yes





*HCPCS/Rates/Hipps

Rate Codes





 

      Section

14. Incorporation by Reference. (1) The following material is incorporated by

reference:

      (a)

"Kentucky Inpatient and Outpatient Data Coordinator's Manual for

Hospitals", revised October 1, 2015[December 1, 2014]; and

      (b)

"Kentucky Data Coordinator's Manual for Ambulatory Facilities,"

revised October 1, 2015[December 1, 2014].

      (2)

This material may be inspected, copied, or obtained, subject to applicable

copyright law, at the Cabinet for Health and Family Services, 275 East Main

Street 4WE, Frankfort, Kentucky, 40621, Monday through Friday, 8 a.m. to 4:30

p.m.

 

ERIC

FRIEDLANDER, Acting Executive Director

AUDREY

TAYSE HAYNES, Secretary

      APPROVED

BY AGENCY: October 8, 2015

      FILED

WITH LRC: October 14, 2015 at 1 p.m.

      PUBLIC

HEARING AND PUBLIC COMMENT PERIOD: A public hearing on this administrative

regulation shall, if requested, be held on November 23, 2015, at 9:00 a.m. in Suite

B, Health Services Building, First Floor, 275 East Main Street, Frankfort,

Kentucky 40621. Individuals interested in attending this hearing shall notify

this agency in writing by November 16, 2015, five (5) workdays prior to the

hearing, of their intent to attend. If no notification of intent to attend the

hearing is received by that date, the hearing may be cancelled. The hearing is

open to the public. Any person who attends will be given an opportunity to

comment on the proposed administrative regulation. A transcript of the public

hearing will not be made unless a written request for a transcript is made. If

you do not wish to attend the public hearing, you may submit written comments

on the proposed administrative regulation. You may submit written comments

regarding this proposed administrative regulation until November 30, 2015. Send

written notification of intent to attend the public hearing or written comments

on the proposed administrative regulation to:

      CONTACT

PERSON: Tricia Orme, Office of Legal Services, 275 East Main Street 5 W-B,

Frankfort, Kentucky 40601, phone 502-564-7905, fax 502-564-7573, email address

tricia.orme@ky.gov

 

REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT

 

Contact

Person: Diona Mullins

      1.

Provide a brief summary of:

      (a)

What this administrative regulation does: This administrative regulation

provides clarification and instruction to specified health care providers on

the process necessary to submit copies of administrative claims data to the

Cabinet.

      (b)

The necessity of this administrative regulation: This administrative regulation

is necessary so that health care providers have a uniform mechanism with

timeframes and instructions with which to submit the required data. The

administrative regulation contains the updated data submission manuals for

hospitals and ambulatory care facilities. The following revisions to the

manuals were necessary: Kentucky Spirit of Kentucky, add end date of 1/1/2015;

and name change for Coventry Cares of Kentucky to Aetna Better Health of

Kentucky effective 2/1/2016.

      (c)

How this administrative regulation conforms to the content of the authorizing

statutes: This administrative regulation is necessary to ensure that health

care providers have a uniform mechanism with timeframes and instructions with

which to submit the required data to enable the Cabinet to publish the data and

reports as required by KRS 216.2925.

      (d)

How this administrative regulation currently assists or will assist in the

effective administration of the statutes: This administrative regulation

provides detailed instructions to specified health care providers relating to

the data elements, forms and timetables necessary to comply with the statute.

      2.

If this is an amendment to an existing administrative regulation, provide a

brief summary of:

      (a)How

the amendment will change this existing administrative regulation: This

administrative regulation incorporates by reference updated data reporting

manuals. The following revisions to the manuals were necessary: Kentucky Spirit

of Kentucky, add end date of 1/1/2015; and name change for Coventry Cares of

Kentucky to Aetna Better Health of Kentucky effective 2/1/2016.

      (b)

The necessity of the amendment to this administrative regulation: This

amendment is necessary to provide new data submission manuals to facilities to

ensure accuracy of the submitted data.

      (c)

How the amendment conforms to the content of the authorizing statutes: This

amendment conforms to the content of the authorizing statute by providing a

standardized method of reporting by hospitals and ambulatory care facilities.

      (d)

How the amendment will assist in the effective administration of the statutes:

The amendment will assist in the effective administration of the statutes as it

provides detailed instructions for submission of required data elements.

      3.

List the type and number of individuals, businesses, organizations, or state

and local governments affected by this administrative regulation: This

administrative regulation will affect the hospitals and ambulatory facilities

which are required to submit data to the Cabinet.

      4.

Provide an analysis of how the entities identified in question (3) will be

impacted by either the implementation of this administrative regulation, if

new, or by the change, if it is an amendment, including:

      (a)

List the actions that each of the regulated entities identified in question (3)

will have to take to comply with this administrative regulation or amendment: Each

entity will collect and submit data as required. Entities are already required

to submit data. This administrative regulation incorporates by reference

updated data reporting manuals. The following revisions to the manuals were

necessary: Kentucky Spirit of Kentucky, add end date of 1/1/2015; and name

change for Coventry Cares of Kentucky to Aetna Better Health of Kentucky effective

2/1/2016.

      (b)

In complying with this administrative regulation or amendment, how much will it

cost each of the entities identified in question (3): Each entity will collect

and submit data as required. Entities are already required to submit data. This

regulation incorporated by reference manuals that were revised to provide detailed

submission requirements. Therefore, no additional cost will be incurred by entities

to comply with this amendment.

      (c)

As a result of compliance, what benefits will accrue to the entities identified

in question (3): Data integrity is improved as all applicable payer codes are

now included in the manuals and instructions have been provided related to the

addition of the requirement to report all outpatient procedures.

      5.

Provide an estimate of how much it will cost the administrative body to

implement this administrative regulation:

      (a)

Initially: No additional costs will be incurred to implement this

administrative regulation. The Office of Health Policy currently collects data

and has the necessary data collection system in place.

      (b)

On a continuing basis: No additional costs will be incurred.

      6.

What is the source of the funding to be used for the implementation and

enforcement of this administrative regulation: The source of funding for the

implementation and enforcement of this administrative regulation will be the

Office of Health Policy’s existing budget. No new funding will be needed to

implement the provisions of the amended regulation.

      7.

Provide an assessment of whether an increase in fees or funding will be

necessary to implement this administrative regulation, if new, or by the change

if it is an amendment: No increase in fees or funding is necessary.

      8.

State whether or not this administrative regulation established any fees or

directly or indirectly increased any fees: This administrative regulation does

not establish any fees and does not increase any fees either directly or

indirectly.

      9.

TIERING: Is tiering applied? Tiering was not appropriate in this administrative

regulation because the administrative regulation applies equally to all those

individuals or entities regulated by it.

 

FISCAL NOTE ON STATE OR LOCAL GOVERNMENT

 

      1.

What units, parts or divisions of state or local government (including cities,

counties, fire departments, or school districts) will be impacted by this administrative

regulation? This amendment impacts the Office of Health Policy and may impact

any government owned, controlled or proposed hospitals and ambulatory care

facilities.

      2.

Identify each state or federal statute or federal regulation that requires or

authorizes the action taken by the administrative regulation. The authorizing

statutes are KRS 216.2920-216.2929.

      3.

Estimate the effect of this administrative regulation on the expenditures and

revenues of a state or local government agency (including cities, counties,

fire departments, or school districts) for the first full year the

administrative regulation is to be in effect.

      (a)

How much revenue will this administrative regulation generate for the state or

local government (including cities, counties, fire departments, or school

districts) for the first year? This administrative regulation will not generate

any revenue.

      (b)

How much revenue will this administrative regulation generate for the state or

local government (including cities, counties, fire departments, or school

districts) for subsequent years? This administrative regulation will not

generate any revenue.

      (c)

How much will it cost to administer this program for the first year? No

additional costs will be incurred to implement this administrative regulation.

      (d)

How much will it cost to administer this program for subsequent years? No

additional costs will be incurred to implement this administrative regulation

on a continuing basis.

      Note:

If specific dollar estimates cannot be determined, provide a brief narrative to

explain the fiscal impact of the administrative regulation.

      Revenues

(+/-): None

      Expenditures

(+/-): None

      Other

Explanation: None
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