570 Rate-setting methodology for consolidated and person/family directed support waiver-funded and base-funded services for individuals participating in the Office of Developmental Programs service system

Rate-Setting Methodology for Consolidated and Person/Family Directed Support Waiver-Funded and Base-Funded Services for Individuals Participating in the Office of Developmental Programs Service System

[46 Pa.B. 1709]
[Saturday, April 2, 2016]

 The Department of Human Services (Department) is providing final notice of the methodology used in the Prospective Payment System (PPS) to develop rates for residential habilitation eligible and transportation trip services funded through the Consolidated and Person/Family Directed Support (P/FDS) waivers.

 The Department published notice of the methodology used in the PPS at 45 Pa.B. 3441 (June 27, 2015). The Department received no public comments during the comment period. The Department will implement the methodology described in the proposed notice with the exception of new providers shall bill the retention factor.

 The Department instructed providers to bill the retention factor separately from the residential eligible rate using the approved procedure codes and modifiers from July 1, 2015, until July 21, 2015. The retention factor only included the applicable state portion for this period of time. Effective July 22, 2015, as approved by the Centers for Medicare and Medicaid Services, the residential eligible rate includes the retention factor.

 Copies of this notice may be obtained at the local Mental Health/Intellectual Disability (MH/ID) County Program, Administrative Entity (AE) or regional Office of Developmental Programs (ODP) in the corresponding regions:

 • Western region: Piatt Place, Room 4900, 301 5th Avenue, Pittsburgh, PA 15222, [phone]

 • Northeast region: Room 315, Scranton State Office Building, 100 Lackawanna Avenue, Scranton, PA 18503, [phone]

 • Southeast region: 801 Market Street, Suite 5071, Philadelphia, PA 19107, [phone] or [phone]

 • Central region: Room 430, Willow Oak Building, P. O. Box 2675, DGS Annex Complex, Harrisburg, PA 17105, [phone]

 Contact information for the local MH/ID County Program or AE may be found at https://www.hcsis.state.pa.us/hcsis-ssd/pgm/asp/PRCNT.ASP or contact the previously referenced regional ODP.

 Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, Office of Developmental Programs, Division of Provider Assistance and Rate Setting, 4th Floor, Health and Welfare Building, 625 Forster Street, Harrisburg, PA 17120. Comments can also be sent to [e-mail], use subject header ''PN PPS Methodology.''

 Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at [phone] (TDD users) or [phone] (voice users).

Fiscal Impact

 It is anticipated that there will be an approximate cost to the Commonwealth of $64.232 million ($35.309 million State Funds) in Fiscal Year 2015-2016 and Fiscal Year 2016-2017 each.

THEODORE DALLAS, 
Secretary

 Fiscal Note: 14-NOT-1001. (1) General Fund;

 (7) Intellectual Disabilities—Community Waiver Program; (2) Implementing Year 2015-16 is $34,754,000; (3) 1st Succeeding Year 2016-17 is $34,754,000; 2nd Succeeding Year 2017-18 through 5th Succeeding Year 2020-21 are $18,260,000; (4) 2014-15 Program—$1,074,000,000; 2013-14 Program—$1,026,000,000; 2012-13 Program—$931,885,000;

 (7) Intellectual Disabilities—Community Base Program; (2) Implementing Year 2015-16 is $555,000; (3) 1st Succeeding Year 2016-17 through 5th Succeeding Year 2020-21 are $555,000; (4) 2014-15 Program—$149,681,000; 2013-14 Program—$150,918,000; 2012-13 Program—$151,223,000;

 (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 16-570. Filed for public inspection April 1, 2016, 9:00 a.m.]