This plan amendment changes the APR grouper from TRICARE DRG v. 35 to APR DRG v. 40. The SPA further sets out the updated calculation of prospective base rates including adjustments for each hospital’s Medicaid Inpatient Utilization Rate (MIUR), Indirect Medical Education (IME) if applicable, Peer Group Add-On Amount if applicable, and a stop-loss/stop-gain adjustment if applicable.
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File 1 - Approval Document Media