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ANNOUNCEMENTS > FY 10-11 Ratesetting for Consolidated and PFDS Waiver Programs


14 Jan 2011

Today, ODP announced that they have "finalized various components of the FY 2011-2012 (Year 3) rate-setting methodology"  for Consolidated and P/FDS Waiver programs.   A rate adjustment factor has NOT YET been determined.  

Click here for the entirety of the memorandum.   

Following are some of the highlights.

  • There are varying processes for identification of outliers.
  • ODP staff will perform a standardized review of all total unit cost outliers that are not +/- 5% of the FY 10-11 rate.
  • Providers will be assigned the lowest rate of approved costs reports if they did not attempt to submit a cost report submission by the deadline, attempted a cost report submission  but failed the hard edits for the upload, or successfully submitted a cost report but did not resubmit as requested during the desk review process.
  • Providers who failed the initial desk review process, and resubmitted during the desk review process but still failed, will be assigned the 25th percentile rate calculated based on all approved cost reports for all services.
  • An occupancy factor will be incorporated into the FY 11-12 ratesetting; thus, providers will not be able to bill for vacancies or temporary leave days under any circumstances, but only for the days where the participant is receiving services.