Proposed Fee Schedule Rates for Transportation (Per Trip) Services Funded Through the Consolidated, Person/Family Directed Support and Community Living Waivers and the Community Intellectual Disability Base-Funded Program
[48 Pa.B. 3827]
[Saturday, June 23, 2018]
The purpose of this notice is to announce the Department of Human Services' (Department) new proposed Fee Schedule Rates for Transportation (per trip) effective January 1, 2019.
The proposed Fee Schedule Rates for Transportation (per trip) in this notice also serve as the Department-established fees for this service under 55 Pa. Code § 4300.115(a) (relating to Department established fees) for base-funded services managed through county programs for individuals with an intellectual disability under the Mental Health and Intellectual Disability Act of 1966 (50 P.S. §§ 4104—4704); 55 Pa. Code Chapter 4300 (relating to county mental health and intellectual disability fiscal manual) and 55 Pa. Code Chapter 51 (relating to Office of Developmental Programs home and community-based services).
Fee Schedule Rates for Transportation (Per Trip)
The proposed Fee Schedule Rates for Transportation (per trip) were developed using a market-based approach. This process included a review of the service definition and a determination of allowable cost components which reflected costs that are reasonable, necessary and related to the delivery of the Transportation (per trip) service, as defined in the Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards (OMB Circular Uniform Guidance, December 26, 2014). The Department established the Transportation (per trip) Fee Schedule Rates to fund services at a level sufficient to ensure access and encourage provider participation, while at the same time ensuring cost effectiveness and fiscal accountability. The Fee Schedule Rates represent the maximum rates that the Department will pay for the Transportation (per trip) service. In developing the proposed Fee Schedule Rates for the Transportation (per trip) service, the following occurred:
The Department evaluated and used various independent data sources such as a Commonwealth-specific compensation study and expense data from prior approved cost reports, as applicable, to ensure the rates reflect the expected expenses for the delivery of the service under the waivers for the major allowable cost categories listed as follows:
• Staff wages
• Staff-related expenses
• Program and administration-related expenses
• Approved service definitions in the waivers and determinations made about allowable cost components that reflect expenses necessary and related to the delivery of each service
• Cost of implementing Federal and State statutes as well as regulations and local ordinances
One Fee Schedule Rate was developed for each zone covered in the Transportation (per trip) service. The modifier identifies when an aide is present during the provision of the service.
Relatives and legal guardians are permitted to provide the Transportation (per trip) service. This service will be available from providers who enroll directly with the Department to provide Transportation (per trip) services and through Organized Health Care Delivery System (OHCDS) providers. There is at least one OHCDS provider in each county.
Fee Schedule Rates for Transportation (Per Trip) Effective January 1, 2019
Modifier U2 is used to identify when an aide is present during the provision of the Transportation (per trip) service.
When Transportation (per trip) is provided through an OHCDS, the appropriate provider type is 55 and the specialty is 267. When the service is provided by a transportation provider that enrolls directly with the Department the appropriate provider type is 26 and the specialty is 267.
Service Name Unit of Service Procedure
Modifier Statewide Fee Transportation
W7274 $11.27 W0025 W0026 Zone 1
W7274 U2 $12.69 W0025 W0026 Zone 2
W7275 $26.08 W0025 W0026 Transportation
W7275 U2 $29.36 W0025 W0026 Zone 3
(over 30 miles)
W7276 $38.89 W0025 W0026 Zone 3
(over 30 miles
W7276 U2 $43.76 W0025 W0026
It is anticipated that there will be no fiscal impact to the Commonwealth in Fiscal Year 2018-2019 and subsequent years as a result this notice. The amount of funding available for this program is dependent upon the funds appropriated by the General Assembly for the forthcoming fiscal year.
Comments received within 30 days of publication of this notice will be reviewed and considered for revisions to the proposed rates. A notice will be published announcing the final Fee Schedule Rates after the public comment period. Interested persons are invited to submit written comments regarding proposed Transportation (per trip) Fee Schedule Rates to 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. Comments can also be sent to email@example.com. Use subject header ''PN Fee Schedule.''
Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service by dialing 711 or by using one of the toll free numbers: (800) 654-5984 (TDD users), (800) 654-5988 (voice users), (844) 308-9292 (Speech-to-Speech) or (844) 308-9291 (Spanish).
Copies of this notice may be obtained at the local Mental Health/Intellectual Disability County Program, Administrative Entity or regional Office of Developmental Programs in the corresponding regions:
• Western region: Piatt Place, Room 4900, 301 5th Avenue, Pittsburgh, PA 15222, (412) 565-5144
• Northeast region: Room 315 Scranton State Office Building, 100 Lackawanna Avenue, Scranton, PA 18503, (570) 963-4749
• Southeast region: 801 Market Street, Suite 5071, Philadelphia, PA 19107, (215) 560-2242 or (215) 560-2245
• Central region: P.O. Box 2675, Harrisburg, PA 17105, (717) 772-6507
TERESA D. MILLER,
Fiscal Note: 14-NOT-1246. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 18-980. Filed for public inspection June 22, 2018, 9:00 a.m.]
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