Pennsylvania Code & Bulletin

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 51 Pa.B. 1768 (March 27, 2021).

55 Pa. Code § 6210.77. Cost finding.

§ 6210.77. Cost finding.

 (a)  The direct allocation method of cost finding shall be used.

 (b)  The costs of ancillary and administrative services shall be apportioned directly to the appropriate level of care based on appropriate statistical data.

 (c)  A facility’s direct or indirect allowable costs related to care shall be considered in the finding and allocation of costs to the MA Program for its eligible recipients. Total allowable costs of a facility shall be apportioned between third-party payors and other recipients so that the share borne by MA is based upon actual services and costs related to MA recipients. For purposes of MA reimbursement, the return on net equity and net worth is not reimbursable.

Cross References

   This section cited in 55 Pa. Code §  6210.35 (relating to ongoing provider responsibilities).

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