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160 S. Progress Avenue, Suite 1-A, Harrisburg, PA 17109
Phone: 717-671-4602 FAX: 717-671-4604
ANNOUNCEMENTS > Community MR Programs

Trying to keep up?
17 Sep 2010

Now is a very busy time of year for providers, especially if you provide multiple services!   For the Community MR programs (Consolidated Waiver and P/FDS), there are a few things "in progress" that you should be aware of.

  • FY 2009-10 cost reports should be in preparation now, as they are due no later than October 17, 2010.
  • You must submit a test report by October 8, 2010.
  • FY 10-11 "proposed rates" were issued in May, 2010.   FY 10-11 "preliminary final" rates were issued via email September 9, 2010.   FY 10-11 "final rates" are scheduled to be issued via email and regular mail on September 20, 2010.   Appeals must be filed within 30 days, if you are appealing. 
  • You should have noticed a slight increase between the proposed rates and the preliminary final rates, due to the change in the RAF (rate adjustment factor) imposed by ODP upon your unit cost with adjustments.
  • You will not likely see a change between the preliminary final rate issued on September 9 and the final rates scheduled to be issued on September 20. 
  • The revenue reconciliation "process" has gone through many revisions over the past year.   The latest submissions by providers were the Quarter 4 adjustment forms that were submitted on or before July 14, 2010.   As of September 17, 2010, we are still waiting for followup to those forms, and we have been told that the Quarter 4 "payment/recoupments" will be issued at the end of September or early October.  Watch for this letter via email and regular mail!!    The letter will contain your revenue target including adjustments.  You have 30 days to appeal the adjusted revenue target.
  • As of now, revenue reconciliation is not scheduled for FY 11-12.   It is extremely important to file accurate FY 2009-10 cost reports and to follow through on that process until they are accepted.   These cost reports will become the basis for rate calculations for FY 11-12.  Without revenue reconciliation, you will be forced to operate on those rates.
  • If you are struggling with significantly reduced rates in FY 10-11, you should be seeking relief from ODP in the form of gross adjustments.  Gross adjustments require the provider to document cash flow difficulties, billing problems, etc., and if approved, will generate a lumpsum payment to the provider which should carry them over until the first revenue reconciliation payment/recoupment on or about January 31, 2011.  Gross adjustment payments to providers will later be offset against future billings/revenues.  The success of this process is also dependent on a satisfactory revenue target.