NOTICES
Medical Assistance Fee Schedule; Final Rates for Transition Service Coordination Administered Through Waivers
[47 Pa.B. 1600]
[Saturday, March 11, 2017]This notice announces the Department of Human Services (Department) final Medical Assistance (MA) fee schedule rates for Transition Service Coordination administered through the Aging, Attendant Care, COMMCARE, Independence and OBRA waivers (waivers) effective December 1, 2016.
Background
Effective December 1, 2016, the Department eliminated the four post-transition outcome payments for successful transition and monitoring, totaling $2,500, at specified intervals during the participant's first year in the community, for participants in waivers and increased the MA fee schedule rates for Transition Service Coordination (procedure code W7337). Pre-transition services will be billed as Transition Service Coordination for waiver participants. This allows the Department to receive Federal Financial Participation for pre-transition services provided to participants in a waiver.
Fee Schedule Rates
Under 55 Pa. Code § 52.45(a) and (b) (relating to fee schedule rates), the Department has increased the MA fee schedule rate for Transition Service Coordination administered through the waivers.
The Transition Service Coordination rate (procedure code W7337) increased from $10 per unit Statewide to the corresponding rates paid for Service Coordination (procedure code W1011).
Rate-Setting Methodology
The Department developed the final MA fee schedule rates using a standardized market-based rate setting methodology. Relevant market-based information used to determine the fee schedule rates included Common-wealth-specific wage information from the Center for Workforce Information and Analysis, Occupational Wages by County, Bureau of Labor Statistics Employer Costs, cost surveys from providers, Medicare rate information and MA State Plan Fee Schedules.
Public Process
The Department published the ''Changes to the Medical Assistance Fee Schedule'' notice at 46 Pa.B. 6939 (October 29, 2016) announcing the proposed MA fee schedule rates and invited interested persons to submit comments. No comments were received by the Department in response to the proposed notice.
The final MA fee schedule rates are available on the Department's web site at http://www.dhs.pa.gov/provider/longtermcareprov/ or by contacting April Leonhard, Department of Human Services, Office of Long-Term Living at (717) 783-8412.
Fiscal Impact
The net fiscal impact is budget neutral. However, costs will shift between appropriations as a result of this change.
Public Comment
Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, Office of Long-Term Living, Bureau of Policy and Regulatory Management, Attention: HCBS Waiver Rate, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments received within 30 days will be considered in subsequent revisions to the fee schedule.
Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
THEODORE DALLAS,
SecretaryFiscal Note: 14-NOT-1118. (1) General Fund;
(7) Long-Term Care; (2) Implementing Year 2016-17 is -$459,000; (3) 1st Succeeding Year 2017-18 through 5th Succeeding Year 2021-22 are -$786,000; (4) 2015-16 Program—$968,083,000; 2014-15 Program—$810,545,000; 2013-14 Program—$820,409,000;
(7) Attendant Care; (2) Implementing Year 2016-17 is $13,000; (3) 1st Succeeding Year 2017-18 through 5th Succeeding Year 2021-22 are $22,000; (4) 2015-16 Program—$161,741,000; 2014-15 Program—$137,229,000; 2013-14 Program—$116,084,000;
(7) Services to Persons with Disabilities; (2) Implementing Year 2016-17 is $196,000; (3) 1st Succeeding Year 2017-18 through 5th Succeeding Year 2021-22 are $335,000; (4) 2015-16 Program—$339,077,000; 2014-15 Program—$273,538,000; 2013-14 Program—$233,104,000;
(7) Home and Community-Based Services; (2) Implementing Year 2016-17 is $250,000; (3) 1st Succeeding Year 2017-18 through 5th Succeeding Year 2021-22 are $429,000; (4) 2015-16 Program—$261,945,000; 2014-15 Program—$132,951,000; 2013-14 Program—$225,008,000;
(8) recommends adoption. The net fiscal impact would be budget neutral. Costs would shift between appropriations as a result of this change.
[Pa.B. Doc. No. 17-446. Filed for public inspection March 10, 2017, 9:00 a.m.]
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