|
Allowable Units and Rates – Per Service and Per Region/County | |
|
Are the units listed in the Service Standards (Attachment C, in each service’s respective “Billable Units” Section), the only approved units that can be included in an agency’s proposal application (the Excel template)? Can a different cost structure be submitted for each county based on actual costs per service? This would be for proposals applying to serve multiple counties. It may be prohibitive to provide services in rural areas with the newly established reimbursement maximums and service standards. Can an agency justify actual service costs and submit for reimbursement consideration? Can a provider propose different rates for different counties within a region? Costs may vary from county to county depending on the demographics. If a service standard has a standard rate but the agency believes that this standard rate does not meet its needs, should we assume that the agency should submit a budget for that service standard? |
The only billing units or “payment points” allowed for each Service Standard are those listed within the Standard. Each Region will contract for services individually; therefore the cost of each unit proposed is to be the same within each Region. Unit rates for the same provider can be different from one Region to another. All costs to the DCS for the services proposed must be included in the specified unit rates. No other payments will be made by the DCS. Providers have the ability to request rates higher than the maximum rate listed in many of the Service Standards, but must submit budgets to justify these rates. Decisions regarding the validity of these requests will be made as part of the evaluation process and can, at the request of the DCS, involve negotiations with the provider. |