NOTICES
DEPARTMENT OF
HUMAN SERVICES
Fee Schedule Rates for Select Services Funded Through the Office of Developmental Programs' Consolidated, Community Living, Person/Family Directed Support and Adult Autism Waivers
[52 Pa.B. 2656]
[Saturday, April 30, 2022]The Department of Human Services (Department) is providing final notice of the Fee Schedule Rates for Family Medical Support Assistance services funded through the Consolidated, Community Living and Person/Family Directed Support (P/FDS) Waivers, Remote Community Participation Support/Day Habilitation services funded through the Consolidated, Community Living, P/FDS, and Adult Autism Waivers, and Medically Complex Life Sharing services and Transition to Independent Living payments funded through the Consolidated Waiver.
The Fee Schedule Rates for Family Medical Support Assistance services, Medically Complex Life Sharing services and Transition to Independent Living payments will be effective upon approval by the Centers for Medicare & Medicaid Services (CMS) of amendments to the Consolidated, Community Living and P/FDS Waivers that addresses these services. The Waiver amendments were submitted to CMS on January 3, 2022, with a proposed effective date of May 1, 2022. The Office of Developmental Programs (ODP) will notify stakeholders of the approved effective date of the Waiver amendments and rates through publication of a communication by means of ODP's Listservs.
The Fee Schedule Rates for Remote Community Participation Support/Day Habilitation services will be added to the Fee Schedule and be effective 6 months after the expiration of the Federal novel coronavirus (COVID-19) public health emergency.
Background
The proposed Fee Schedule Rates for Family Medical Support Assistance services, Remote Community Participation Support services, Medically Complex Life Sharing services and Transition to Independent Living payments were published at 51 Pa.B. 6564 (October 16, 2021). The Department received comments from 30 stakeholders regarding the proposed Fee Schedule Rates. A summary of the comments received, and the Department's responses is available at https://www.dhs.pa.gov/providers/Providers/Documents/ODP/Public%20Notices%20Related%20to%20%20Rates/Summary%20of%20Rate%20Comments%20for%20Services%20Impacted%20By%202022%20 Amendments.pdf. After reviewing the comments on the proposed rates, the Department determined that no changes were necessary to the Fee Schedule Rates.
The final Fee Schedule Rates represent the maximum rates the Department will pay for each service. The final Fee Schedule Rates are included in the following table and can also be found online at https://www.dhs.pa.gov/providers/Providers/Pages/ODP-Rates.aspx.
Service Name Staffing Level Procedure Code Statewide Fee Enhanced Communication Statewide Fee Medically Complex Life Sharing
Needs Group 4
1-person home TBD $435.94
(day unit)$501.33
(day unit)2-person home TBD $274
(day unit)$315.10
(day unit)Family Medical Support Assistance 1:1 TBD $18.41
(15-minute unit)$21.17
(15-minute unit)Remote Community Participation Support/Day Habilitation 1:1 to 1:5 TBD $4.94
(15-minute unit)$5.68
(15-minute unit)1:6 and above TBD $1.91
(15-minute unit)$2.20
(15-minute unit)Transition to Independent Living Payment First Payment TBD $15,000
(paid when outcome achieved)N/A Second Payment TBD $15,000
(paid when outcome achieved)N/A Copies of this notice may be obtained by contacting the Department of Human Services, Office of Developmental Programs, Division of Provider Assistance and Rate Setting, 4th Floor, Health and Welfare Building, 625 Forster Street, Harrisburg, PA 17120, ra-ratesetting@pa.gov.
Fiscal Impact
It is anticipated that there will be a total net savings to the Commonwealth in Fiscal Year (FY) 2021-2022 of $0.049 million ($0.020 million in State funds). The net fiscal impact for FY 2021-2022 to Intellectual Disabilities—Community Waiver Program is a cost of $0.541 million ($0.222 million in State funds) and to Medical Assistance—Capitation is a savings of $0.589 million ($0.242 million in State funds).
In FY 2022-2023 is anticipated there will be additional net savings to the Commonwealth of $5.207 million ($2.494 million in State funds). The net fiscal impact for FY 2022-2023 to Intellectual Disabilities—Community Waiver Program is a savings of $0.492 million ($0.244 million in State funds) and to Medical Assistance—Capitation is a savings of $4.715 million ($2.250 million in State funds).
In FY 2023-2024 and subsequent years, it is anticipated that there will be additional net savings to the Commonwealth of $10.224 million ($4.908 million in State funds). The net fiscal impact for FY 2023-2024 and subsequent years to Intellectual Disability—Community Waiver Program is a savings of $5.510 million ($2.645 million in State funds) and to Medical Assistance—Capitation is a savings of $4.715 million ($2.263 million in State funds).
MEG SNEAD,
Acting SecretaryFiscal Note: 14-NOT-1506. (1) General Fund;
(7) Intellectual Disabilities—Community Waiver Program; (2) Implementing Year 2021-22 is $222,000; (3) 1st Succeeding Year 2022-23 is -$244,000; 2nd Succeeding Year 2023-24 through 5th Succeeding Year 2026-27 are -$2,645,000; (4) 2020-21 Program—$1,622,000,000; 2019-20 Program—$1,664,000,000; 2018-19 Program—$1,644,000,000;
(7) Medical Assistance—Capitation; (2) Implementing Year 2021-22 is -$242,000; (3) 1st Succeeding Year 2022-23 is -$2,250,000; 2nd Succeeding Year 2023-24 through 5th Succeeding Year 2026-27 are -$2,263,000; (4) 2020-21 Program—$3,060,000,000; 2019-20 Program—$2,508,000,000; 2018-19 Program—$3,304,000,000;
(8) recommends adoption. Funds have been accounted for in the budget.
[Pa.B. Doc. No. 22-641. Filed for public inspection April 29, 2022, 9:00 a.m.]
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