Home » 2010 Issues » September 29, 2010 » MRD-28-10-00017-A Revision of the Reimbursement Methodologies for Various Facilities and Services Provided Under the Auspices of OPWDD
MRD-28-10-00017-A Revision of the Reimbursement Methodologies for Various Facilities and Services Provided Under the Auspices of OPWDD
9/29/10 N.Y. St. Reg. MRD-28-10-00017-A
NEW YORK STATE REGISTER
VOLUME XXXII, ISSUE 39
September 29, 2010
RULE MAKING ACTIVITIES
OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES
NOTICE OF ADOPTION
I.D No. MRD-28-10-00017-A
Filing No. 946
Filing Date. Sept. 14, 2010
Effective Date. Oct. 01, 2010
Revision of the Reimbursement Methodologies for Various Facilities and Services Provided Under the Auspices of OPWDD
PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following action:
Action taken:
Amendment of sections 635-10.5, 671.7, 679.6, 681.14, 686.13 and 690.7 of Title 14 NYCRR.
Statutory authority:
Mental Hygiene Law, sections 13.07, 13.09(b) and 43.02
Subject:
Revision of the reimbursement methodologies for various facilities and services provided under the auspices of OPWDD.
Purpose:
To implement Health Care Adjustment (HCA) VI.
Substance of final rule:
The regulations for Health Care Adjustment (HCA) VI represent the most recent in an annual series of initiatives to continue the momentum to support and sustain provider agencies in addressing the health care needs of their staff. OPWDD recognizes the essential role staff, especially direct support workers, play in developing and maintaining a high quality service delivery system. These funding initiatives will enable providers to sponsor or continue to sponsor attractive employee health care related benefits and may simultaneously serve to facilitate recruitment and retention efforts.
Medicaid funded services covered by these initiatives at various funding levels include Residential Habilitation, Day Habilitation, Supported Employment, Prevocational Services, Respite, Community Residential Habilitation, Article 16 Clinics, ICF/DDs, Day Treatment, Plan of Care Support Services and Family Education and Training.
OPWDD has determined a benchmark of health care coverage and has identified provider agencies that meet or exceed the benchmark criteria. In recognition of health care costs being incurred and to serve as a model toward which all providers should strive, providers which offer coverage at or above the benchmark will receive either a 3.0 percent increase to their allowable operating costs per trended program or a 1.0 percent increase to their allowable operating costs per all covered programs. Providers not in this category may apply to OPWDD to receive funding equivalent to 1.0 percent of their allowable operating costs in their rates or prices in the covered programs. The application must specify the intended use of the funds which are, first, to offset health care premium increases and, if any funds remain, to establish health care related benefits or to reduce employee out-of-pocket health care related expenses. Non-benchmark providers must assure board authorization and agree to maintain records to substantiate distribution of these funds consistent with their applications.
In all instances, the increases will be calculated based on the rates, prices or fees in effect on April 1, 2010 and will be a fixed amount thereafter. There will also be Health Care Adjustment VI payments in the amounts providers would have received if the increase had become effective on April 1, 2010.
Final rule as compared with last published rule:
Nonsubstantive changes were made in sections 635-10.5, 671.7, 679.6, 681.14, 686.13 and 690.7.
Text of rule and any required statements and analyses may be obtained from:
Barbara Brundage, Director, Regulatory Affairs Unit, OPWDD, 44 Holland Avenue, Albany, New York 12229, (518) 474-1830, barbara.brundage@omr.state.ny.us
Additional matter required by statute:
Pursuant to the requirements of the State Environmental Quality Review Act, OMRDD, as lead agency, has determined that the action described herein will have no effect on the environment, and an E.I.S. is not needed.
Regulatory Impact Statement, Regulatory Flexibility Analysis, Rural Area Flexibility Analysis and Job Impact Statement
Chapter 168 of the Laws of 2010 changed the name of the submitting agency from the Office of Mental Retardation and Developmental Disabilities (OMRDD) to the Office for People with Developmental Disabilities (OPWDD). The text of the regulations was amended to reflect the agency's name change. This minor change does not necessitate revision to the previously published Regulatory Impact Statement, Regulatory Flexibility Analysis for Small Business and Local Governments, Rural Area Flexibility Analysis or Job Impact Statement.
