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IDD Update
November 2, 2011

PCPA is requesting that members share the impact of the Office of Developmental Programs (ODP) rate cuts on services. In order for PCPA to advocate at the state level for correction of the six percent rate adjustment factor cut, details are needed from each agency affected. The association also needs to know which agencies will be in the 60 percent bracket that will break even or see increased revenues. Agency names will be held confidential. Please send (to Linda Drummond) by November 7,  details on amount of funding cuts, number of clients affected per type of service, how the agency anticipates addressing these cuts, if the agency plans to close any programs, and, if yes, which ones.

Please also let PCPA know if you are filing a formal rate appeal. If you are filing with the Department of Public Welfare (DPW) Bureau of Hearings and Appeals remember to challenge the rate setting process DPW used as illegal rulemaking in violation of the regulatory review process. If members need a referral to lawyers experienced with filing these appeals, there are several who are PCPA business members.

PCPA asked ODP several questions from our members. The questions and ODP’s response:

1.      When will there be guidance for residential providers regarding how to bill for Ineligible Room and Board, since there was a $5 million cut in this category in the state’s approved budget?
As in years past, there will be policy bulletins outlining the rate methodology and additional details on policy changes that have been announced.  Those will come out shortly.  But your members can utilize the rates they received in our October 14, 2011 letter to plan for all services, including ineligible Room and Board.

2.      For Supports Coordination Organizations (SCOs), is the rate based on the area/location of its corporate office or does it fluctuate depending on the rate at the location of the consumer?
Supports Coordination Organizations should bill for services provided based on their service location code. If services are being provided at a location where the provider does not have a current service location code they can add a new service location code.

PCPA is serving on several restructured ODP committees which are being implemented in cooperation with the national Alliance for Full Participation. The SCO Subcommittee is seeking one SCO and one direct service provider of employment services to volunteer to assist in developing trainings and recommendations related to employment for persons with intellectual disability. Please let Linda Drummond know (linda@paproviders.org) of interest in serving on this subcommittee. 

ODP Updates available at www.odpconsulting.net:

  • Announcement #139-11: ODP Year 4 Desk Review Procedures and Cost Report Submission Deadline Reminder: Final deadline for submitting cost reports and supplemental schedules for Year 4 is Thursday, November 3 at 11:59 pm. The E-Help Desk will close on November 3 at 5:00 p.m. and will not be available for technical assistance during the evening.
  • Announcement #140-11: Enhancements to Service Notices OLTL Only. HCSIS changes in the October 19 release related to service note screens apply only to the Office of Long Term Living.
  • Announcement #141-11: Billing Issue Identified for Claims Submitted October 24. If a provider discovers they submitted a claim on October 24 and were approved for an incorrect payment amount, submit a claim adjustment.
  • Announcement #142-11: 43,000 Service Rates Loaded Inadvertently to HCSIS. Half of the final 2011/12 provider specific rates, effective November 15, 2011 – June 30, 2012 were inadvertently loaded to services in HCSIS on October 26. Providers need to view their service authorization notices before billing for services.
  • Announcement #143-11: ODP Year 4 Cost Report Submission Deadline Reminder: Final deadline for cost report submission is Thursday, November 3 at 11:59 pm. Questions may be submitted to odpcostreporthelp@mercer.com.
  • Announcement #144-11: New Certified Investigator Course: Focusing on Quality, Reconciling Evidence and Concluding the Investigation. Sessions offered across the state beginning November 8.; Additional information is available at www.odpinvestigations.com.
  • 145-11: Clarification on #144-11 hyperlink for Certified Investigator course.
  • #146-11 Informational Packet: AWC FMS Wage and Benefit Ranges and Rates for Specific Participant Directed Services.
  • #147-11: No Change to VF/EA FMS Rate, Wage and Benefit Rates for 2011-12 FY.

Pennsylvania Senate Bill 458, which changes the terminology in the Mental Health/Mental Retardation Act of 1966 from mental retardation to “intellectual disability,” passed the House unanimously and will be forwarded to the governor for his signature (www.legis.state.pa.us).

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