21 Apr 2009
At the recent PAR conference workshop on ODP Fiscal Policy, Joe Church presented the latest regarding the prospective payment system for MR providers in PA. Click here for the power point presentation. Following are some of the highlights from the morning portion of the workshop:
- Stimulus Money: only available through December 31, 2010
- Prudent Pay: An exception has been granted and there will be no prudent pay in this program for FY 2009-10 and FY 2010-11.
- PROMISe Billing: Providers are encouraged to bill more than once per month at a frequency that provides a balance between the administrative effort and the improvement to cash flow. It is noted, however, that the ineligible gross resident occupancy less a person's ability to pay will be billed monthly for now.
- If you have specific comments or suggestions about Schedule D in the cost report, send them to Joe Church, as they are considering revisions.
- There will be improvements for the approval/disapproval process.
- The due date for cost reports is October 15, 2009!!!!! Not November 15, as previously stated by ODP.
- The AE's will due desk reviews in Year 2. There will be some supervision by the Region and there will be spot checking by Mercer to be sure there is consistency across the state.
- ODP anticipates issuing approximately 15,000 individual rates. The executive level of ODP will be reviewing the 15,000 rates.
- Providers should watch for two letters in May: first, there will be rate information from Mercer, then followed by ODP information.
- In addition to other possible adjustments, the new rates will include a 1% COLA adjustment for FY 08-09, but there is currently no COLA adjustment for FY 09-10.
- Revenue Reconciliation: Revenue Reconciliation targets ae subject to change based on discussions with the workgroup. FY 07-08 data will be used, along with adjustments for COLA, initiative funding, changing needs, emergency funding, increased authorizations in the IPP, etc. The targets will be out in June, and the information will show the calculation beginning with the base number plus/minus adjustments. Providers will have the opportunity to respond.
- Quarterly adjustments are now being considered, as opposed to only 1st and 3rd quarter and final as previously proposed.
- The original proposal includes a 95% to 105% range for payments and recoupments. On the table now is to pay out up to 100% and to recoup down to 100%.
- Margin is not in play until FY 2011-12.
- There will be a fiscal person in each Regional Office to resolve issues.
- YES, YOU HAVE THE RIGHT TO APPEAL YOUR RATES. Details will be in the rate letter.