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PRIOR PRINTER'S NO. 1982
PRINTER'S NO. 3392
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1535
Session of
2017
INTRODUCED BY WARD, BULLOCK, PICKETT, DEAN, SOLOMON, ZIMMERMAN,
McGINNIS, RYAN, CHARLTON, CAUSER, BOBACK, KAUFER, PEIFER,
MILLARD, KINSEY, BOYLE, PHILLIPS-HILL, SAYLOR, LONGIETTI,
KAVULICH, GREINER, SANTORA, V. BROWN, WHEELAND, MOUL, WATSON,
ROZZI, HEFFLEY AND NELSON, JUNE 12, 2017
AS REPORTED FROM COMMITTEE ON HUMAN SERVICES, HOUSE OF
REPRESENTATIVES, AS AMENDED, APRIL 18, 2018
AN ACT
Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
act to consolidate, editorially revise, and codify the public
welfare laws of the Commonwealth," in public assistance,
providing for PUBLIC NOTICE OF provider payment rates for
individuals with an intellectual disability or autism.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of June 13, 1967 (P.L.31, No.21), known
as the Human Services Code, is amended by adding a section to
read:
Section 443.12. PUBLIC NOTICE OF Provider Payment Rates for
Individuals with an Intellectual Disability or Autism.--The
following shall apply to home-based and community-based services
provided to individuals with an intellectual disability or
autism:
(1) The department shall maintain and publish in the
Pennsylvania Bulletin on or before December 31 of each fiscal
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year a detailed description of the calculation of providers'
payment rates for home-based and community-based services,
including the data, inputs, assumptions, variables, calculations
and precise methodologies relied on and the source of all data,
variables and assumptions utilized in establishing the payment
rates notwithstanding whether the payment rates are developed by
the department or a third party. The information shall be made
available by the department to each provider, family and
consumer for inspection, examination and copying.
(2) A provider shall submit cost reports to the department,
or the department's designee, on or before September 30 of each
fiscal year that identify the costs incurred to render home-
based and community-based services during the prior fiscal year.
This paragraph shall expire October 1, 2020.
(1) THE DEPARTMENT SHALL PUBLISH IN THE PENNSYLVANIA
BULLETIN ON OR BEFORE MARCH 31 OF EACH YEAR A PUBLIC NOTICE THAT
CONTAINS THE PROPOSED PROVIDER PAYMENT RATES FOR THE NEXT FISCAL
YEAR SUFFICIENT TO ENABLE INDIVIDUALS WITH AN INTELLECTUAL
DISABILITY OR AUTISM, WHO ARE ENROLLED IN ANY OF THE
DEPARTMENT'S FEDERALLY APPROVED MEDICAL ASSISTANCE FUNDED WAIVER
PROGRAMS, TO ACCESS SERVICES WHICH MUST COMPLY WITH THE
DEPARTMENT'S QUALITY OF CARE STANDARDS AND ARE NECESSARY TO MEET
THE NEEDS OF INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR
AUTISM, AS IDENTIFIED IN THE INDIVIDUALS' APPROVED INDIVIDUAL
SUPPORT PLANS.
(2) THE NOTICE SHALL SOLICIT PUBLIC COMMENT ON AND CONTAIN A
DETAILED DESCRIPTION OF THE PRECISE METHODOLOGIES UTILIZED TO
CALCULATE THE PAYMENT RATES FOR HOME-BASED AND COMMUNITY-BASED
SERVICES TO BE RENDERED UNDER THE WAIVER PROGRAMS, INCLUDING THE
DATA, STUDIES, ASSUMPTIONS, VARIABLES, CALCULATIONS AND ANY
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OTHER INFORMATION RELIED UPON AND THE SOURCE OF ALL INFORMATION
UTILIZED IN ESTABLISHING THE PAYMENT RATES. THE INFORMATION
SHALL BE MADE AVAILABLE BY THE DEPARTMENT FOR INSPECTION,
EXAMINATION AND COPYING.
(3) WITHIN FORTY-FIVE DAYS OF THE PASSAGE OF THE GENERAL
APPROPRIATION ACT EACH YEAR, AND AFTER REVIEW AND CONSIDERATION
OF THE PUBLIC COMMENTS RECEIVED BY THE DEPARTMENT, THE
DEPARTMENT, BY NOTICE PUBLISHED IN THE PENNSYLVANIA BULLETIN,
SHALL ADOPT THE FINAL PROVIDER PAYMENT RATES FOR THE FISCAL YEAR
AND SHALL RESPOND IN DETAIL TO THE PUBLIC COMMENTS.
Section 2. This act shall take effect in 60 days.
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