Pennsylvania Code & Bulletin

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 52 Pa.B. 3204 (May 28, 2022).

55 Pa. Code § 6100.645. Rate setting.

§ 6100.645. Rate setting.

 (a)  The Department will use the cost-based rate setting methodology to establish a rate for cost-based services for each provider with a Department-approved cost report.

 (b)  The approved cost report will be used as the initial factor in the rate setting methodology to develop the allowable costs for cost-based services.

 (c)  The provider shall complete the cost report in accordance with this chapter.

 (d)  The cost data submitted by the provider on the approved cost report will be used to set the cost-based rates.

 (e)  Prior to the effective date of the cost-based rates, the Department will publish as a notice in the Pennsylvania Bulletin the cost-based rate setting methodology, including the Statewide process used to review the cost reports, outlier analysis, vacancy factor and rate assignment processes.

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).

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