Section 240.1910 Establishment of Fixed Unit Rates

Section 240

Section 240.1910

Establishment of Fixed Unit Rates

Rate methodologies and rates of

payment for the Persons who are Elderly Waiver program are developed by the

Department with consultation, oversight, and final approval by HFS, the State

Medicaid agency.  During the Waiver's five-year renewal process, the federal

Centers for Medicare and Medicaid Services review the State's Elderly Waiver

compliance, including rate sufficiency.

a)         The fixed unit rates will be reviewed annually, at a minimum,

and adjustments will be made to conform to CCP's appropriation and to program

service requirements and federal and State changes in statutes and rules

affecting CCP.

b)         In establishing fixed unit rates of reimbursement, the

Department will take into consideration the following:

1)         cost information provided by service providers;

2)         current market conditions and trend analyses; and

3)         CCP appropriation levels.