Open for Public Comment: Appendices I and J, Proposed Fee Schedule Rates, and Renewal of the Adult Autism Waiver

ODP Announcement 21-040 shares that the Office of Developmental Programs (ODP) is seeking your valuable feedback and comments on Appendices I and J of the renewal of the Adult Autism Waiver (AAW), as well as the proposed Fee Schedule Rates, the proposed Department-established Fees for residential ineligible services, and the rate setting methodology.

The Centers for Medicare and Medicaid Services (CMS) approves waivers for a five-year period. The current AAW expires on June 30, 2021; however, CMS has granted ODP a 90-day extension on the currently approved AAW through September 28, 2021. The renewal of the AAW, as well as the final rates, will be effective September 29, 2021.

The following substantive changes are proposed to Appendices I and J:

• Homemaker/Chore will be added as an AAW service and has been added to the services for which there will be a Medical Assistance Fee Schedule rate effective September 29, 2021.
• The factors related to estimated annual average per capita Medicaid costs in Appendix J have been updated to reflect the most recent data available. These factors are Factor D’ Derivation, Factor G Derivation, and Factor G’ Derivation.
• The 5-year average cost per unit of service estimates in Appendix J have been updated to reflect the proposed Fee Schedule Rates contained in the public notice.

A public notice regarding these proposed changes can be found in the Pennsylvania Bulletin, Volume 51, Number 21, published on Saturday, May 22, 2021. Appendices I and J, the proposed Fee Schedule Rates, the proposed Department Established Fees, and the assumption logs used to develop the rates and fees are available on the DHS website.

Interested persons are invited to submit written comments regarding Appendices I and J of the AAW as well as the proposed rates. Comments should be addressed to Laura Cipriani, Department of Human Services, Office of Developmental Programs, 625 Forster Street, Room 510, Harrisburg, PA 17120. Comments may also be submitted to ODP. Use the subject header “AAW Rates.” Comments received by 11:59 pm on June 21, 2021 will be reviewed and considered for revisions.