Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

• No statutes or acts will be found at this website.

The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 51 Pa.B. 676 (January 30, 2021).

55 Pa. Code § 6100.642. Assignment of rate.

§ 6100.642. Assignment of rate.

 (a)  The provider will be assigned a cost-based rate for an existing HCBS at the location where the HCBS is delivered, with an approved cost report and audit, as necessary.

 (b)  If the provider seeks to provide a new HCBS, the provider will be assigned the area adjusted average rate of approved provider cost-based rates.

 (c)  A new provider with no historical experience will be assigned the area adjusted average rate of approved provider cost-based rates.

 (d)  If the provider fails to comply with the cost reporting requirements specified in this chapter after consultation with the Department, the provider will be assigned the lowest rate calculated Statewide based on all provider cost-based rates for an HCBS.

 (e)  Compliance with cost reporting requirements will be verified by the Department through a designated managing entity review or an audit, as necessary.

Cross References

   This section cited in 55 Pa. Code §  6100.641 (relating to cost-based rate); 55 Pa. Code §  6100.802 (relating to support coordination, targeted support management and base-funding support coordination); and 55 Pa. Code §  6100.803 (relating to organized health care delivery system).



No part of the information on this site may be reproduced for profit or sold for profit.


This material has been drawn directly from the official Pennsylvania Code full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.