Header Graphic
160 S. Progress Avenue, Suite 1-A, Harrisburg, PA 17109
Phone: 717-671-4602 FAX: 717-671-4604
ANNOUNCEMENTS > ODP issues rate information

10 May 2009

Late Friday, ODP issued information regarding the prospective rate system.  In case you didn't receive the documents in these emails,  I am uploading them here.  Specific provider rate information is supposed to be issued on May 12, 2009; however, you can also check the Services and Supports Directory on HCSIS to see if your rates have been entered.

The payment rates will be used to process claims submitted to PROMISe during the FY 09-10, but final payments to providers in both FY 09-10 and FY 10-11 will be made in accordance with the revenue reconciliation policy.  Revenue Reconciliation targets will be issued by ODP in June 2009.

The Department will consider requests for a gross adjustment payment when a provider encounters a signficant cash flow issue during the transition to the prospective cost based system.  However, providers will have to demonstrate their good faith effort as well as demonstrate the seriousness of the situation, such as ability to pay staff or that the health and safety of the Medicaid recipients is jeopardized.  You also must  allow time (approximately 25 business days) for the Department to review your request, and if approved, process the payment through the Office of the Comptroller.   (AZTAC note:  Providers should consider billing more than once a month, perhaps weekly or bimonthly, to improve cash flow.)

Protocol for Gross Adjustments

Kevin Casey letter dated May 8, 2009 re:  Proposed Payment Rates

Methodology for Calculating Unit Costs

Statistical Unit Costs Analysis Summary

Kevin Casey letter dated May 8, 2009 re:  Proposed Payment Rates for Supports Coordination

Methodology for Calculating Unit Costs for Supports Coordination