Friday, March 9 is the deadline for submitting comments to ODP to  RA-ratesetting@pa.gov on the draft regulations recently sent out by the Office of Development Programs.   Refer to the February 11 and February 18 Pennsylvania Bulletin for complete "notices" and refer to the MR Regulations section of this website for the pdf files for your review.  

It is important for everyone to submit comments on at least one issue!  

AZTAC submitted comments for the ICF/ID regulatory changes.  The most significant changes are:

• the elimination of the inflationary increase
• the inclusion of an undefined rate adjustment factor
• there is no provision for a COLA  

Other changes are the establishment of October 31 as the deadline for submission of waiver requests, and editing changes such as changing MR to ID.    If you would like a copy of the AZTAC comments, please send an email to marilyn@aztacinc.com and  mahaschert@verizon.net or call 717-671-4602..

AZTAC also submitted detailed comments for the new Chapter 51 regulations for Home and Community Based Services (HCBS).  There are many issues worthy of comment in these regulations, naming just a few here:

• The Department is requiring return of funded equity in buildings if the program closes and no longer provides HCBS.
• Providers may only submit one cost report per MPI.
• The ratesetting methodology is not clearly defined.
• The RAF is not clearly defined.
• The outlier methodology is not clearly defined.
• There is no margin in the ratesetting.
• There are many "prior written approvals" that are required.
• There are many "regulations" which allow changes to the regulations simply by notice in the Pennsylvania Bulletin---such as changing the list of services included in fee-for-service--instead of the regulatory process.
• There is a statement that says "A cost not listed in this chapter is not an allowable cost."
• The 5% rate comparison for outliers is eliminated.
• There is a provision for a statewide 95% vacancy factor.
• Billing for therapeutic leave and hospital leave days are eliminated.
• There are references to costs being allowable contingent on the availability of funds--isn't that the purpose of the RAF?
• There are several regulations that micromanage private providers. 
• Prior appoval is required for renovations in excess of 10%  of the original cost of the building.
• If the "current interest rate" is greater than 1.5% below what you are being charged, the Department will determine if you should refinance.
• It is not clear if new long-term interest expense on capital assets is allowable. 
• Donated assets must be listed as both an expense and offsetting revenue.
• Providers will receive lowest rate in the state for failed cost reports.
• Reduction of participation allowance and elimination of participation allowance.
• Many services are moved to fee-for-service.

Even if you don't have time to read and comment on all 114 pages, perhaps read a couple sections and comment on those.   If the Department does not receive enough comments, they will not know what your concerns are.    If you would like an electronic copy of AZTAC's comments, send an email to marilyn@aztacinc.com and mhaschert@verizon.net or call 717-671-4602.

See the regulations link on this website for the draft regulations.