Nursing Facility Processing of Fiscal Year 2017-2018 Rate Adjustments
The notice Payments to Nonpublic and County Nursing Facilities; Final Rates for State Fiscal Year 2017-2018 was published in the Pennsylvania Bulletin on December 23, 2017. For Fiscal Year (FY) 2017-2018, the rate letters for the 1st, 2nd and 3rd quarters were mailed on December 29, 2017 and the rate letters for the 4th quarter were mailed on March 8, 2017. Rate adjustments for the 1st rate quarter of FY 2017-2018 will begin to be processed on March 12, 2018. The processing schedule and the estimated total adjustment and payment/recovery group for each nursing facility is located on the Department of Human Services’ website at http://www.dhs.pa.gov/provider/longtermcarecasemixinformation/nursingfacilityprocessingrates/.
An exceptional payment plan will be implemented for one group. Nursing facilities that owe 25% or more of their average monthly Medical Assistance payment will have the amount owed to the Commonwealth recovered over a 4-month period through PROMISe unless they are located in the southwest Community HealthChoices (CHC) zone.
For nursing facilities that are located in the southwest CHC zone, claims will process all at once in PROMISe to create an accounts payable or receivable. The nursing facilities will be able to see the balance on their remittance advice. If there are any receivables remaining after claim offsets, a letter will be issued. The letter will list a 30-day timeframe for check submission and include a statement for the nursing facility to contact provider operations should they need to arrange for an installment payment plan extending over four months based upon financial hardship.
If you have any questions regarding this email, please contact the Office of Long-Term Living, Bureau of Provider Operations Management, Garth Champaign at 717-705-0494.
A listserv has been established for ongoing updates on the CHC program. It is titled OLTL-COMMUNITY-HEALTHCHOICES, please visit the ListServ Archives page at http://listserv.dpw.state.pa.us to update or register your email address.
Please share this email with other members of your organization as appropriate. Also, it is imperative that you notify the Office of Long-Term Living for changes that would affect your provider file, such as addresses and telephone numbers. Mail to/pay to addresses, email addresses, and phone numbers may be updated electronically through ePEAP, which can be accessed through the PROMISe™ provider portal. For any other provider file changes please notify the Bureau of Quality and Provider Management Enrollment and Certification Section at 1-800-932-0939 Option #1.
To ensure you receive email communications distributed from the Office of Long-Term Living, please visit the ListServ Archives page at http://listserv.dpw.state.pa.us to update or register your email address.