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OMR ICF/MR Assessment Assurances
June 25, 2004

The first meeting of the ICF/MR Assessments Implementation Committee was held June 3 to address the purpose and issues regarding the development of the state’s law and policy requiring all public and private ICFs/MR to be annually assessed up to the allowable maximum of 6% by the Centers for Medicare and Medicaid Services. This is one of several Department of Public Welfare (DPW) strategies to maximize federal revenue. DPW legal counsel has developed draft legislation that would need to be passed this year to allow this assessment to be retroactive to July 1, 2003. Agreements and procedures must then be quickly developed and finalized.

Additional meeting were held with stakeholders to address a variety of fiscal implementation issues. PCPA was represented at a June 16 fiscal meeting by Tim Bean from Beacon Light Behavioral Health Systems and Mary Anne Arthur from Intercommunity Action, Inc.. This information was shared with the stakeholders at the June 17 Implementation Committee. These issues included:

  • What process will be used to make this law retroactive to July 1, 2003?
  • What will be the basis for the assessment? (total revenue, number of beds, etc.)
  • How will interim and changing per diem rates be handled?
  • How will payments be processed?

With the Office of Mental Retardation (OMR) unable to answer many of these concerns as well as being unable to change the draft legislation they had developed, PCPA and other state-level provider associations held a series of emergency meetings with the Department. The result of those meetings was a letter of “assurances” from Deputy Secretary Kevin Casey that agreed to the following:

  • ICF/MR providers may file appeals challenging the accuracy of their individual assessment amount and may appeal as well any enforcement action undertaken by the Department pursuant to section 810-C of the legislation.
  • DPW will work with the provider organizations to implement the legislation that will include the rate setting system that governs payments to ICFs/MR and to minimize any undue administrative burden to the providers.
  • If DPW determines that an enforcement action must be initiated against an ICF/MR it will do so in a manner that is no more severe than any enforcement action it would take against a long-term nursing facility under Act 2003-25.
  • OMR will work with providers to discuss issues relating to the treatment of the assessment as an allowable cost and how the cost may be reported for payment, audit, and cost settlement purposes.
  • DPW will follow the legislative directive that any federal funds received as a direct result of the assessment will fund services for persons with mental retardation for any of the fiscal years covered by the legislation.

For additional information or a copy of the OMR letter please contact Linda Drummond at PCPA.

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