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Tags Posts tagged with "proposed fee schedule rates"

proposed fee schedule rates

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Image by Werner Moser from Pixabay

The Office of Developmental Programs (ODP) is accepting feedback and comments on the proposed Fee Schedule Rates for services funded through the Consolidated, Community Living, P/FDS, and Adult Autism Waivers as well as Base-Funded programs, residential ineligible services, and the accompanying rate assumption logs.

After receiving feedback from our members, we submitted our comments today. We look forward to continued discussion with ODP regarding the development of rates that will sufficiently support services to individuals with ID/A in the community.

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The Office of Developmental Programs (ODP) requests your assistance distributing the following communication: ODPANN 21-040: Open for Public Comment: Appendices I & J, Proposed Fee Schedule Rates, and Proposed Department-Established Fees for the Renewal of the Adult Autism Waiver (AAW). Public comments may be submitted through 11:59 pm on Monday, June 21, 2021. Please review the attached announcement for information on how to submit comments and to view the proposed changes.

RCPA will be submitting comments. Please contact Carol Ferenz, Director of IDD Division, if you have comments you would like us to include.

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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.

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ODP Updates

The Office of Developmental Programs has issued the following information:

  • Announcement #051-15: Waiver Direct Service Provider Audit Requirements for Fiscal Year 2014/2015 Reporting Period; Questions may be directed to ODP Regional Fiscal Officer Agnes Rudolf.
  • Informational Packet #052-15: Rate Retention Factor Process Resulting from Provider Settlement Agreement; Procedures apply only to providers who signed and submitted the Provider Settlement Agreement Addendum.
  • Announcement #053-15: AE Oversight Monitoring Webcast Now Available in AE Information Center.
  • Announcement #054-15: Delay Implementation of Fourth Waiver Amendments for ODP Consolidated and Person/Family Directed Support Waivers Effective July 1, 2015; ODP has not received federal CMS approval for the fourth set of waiver amendments. These amendments were shared in Announcement #039-15.
  • PA Bulletin on June 27 includes the notification of the Proposed Fee Schedule Rates for Fiscal Year 2015/16 for the Consolidated and Person/Family Directed Support Waivers, Target Service Management and Community ID Base-Funded Programs.
  • PA Bulletin on June 27 includes the notification of the Proposed Rate Setting Methodology for the ODP Consolidated and Person/Family Directed Support Waiver and Base-Funded Services for the 2015/16 Fiscal Year.
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