PRINTER'S NO. 2168
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1534
Session of
2015
INTRODUCED BY BENNINGHOFF, COHEN, FARRY, A. HARRIS, KILLION,
MURT, NESBIT, SAYLOR, TOOHIL AND WATSON, SEPTEMBER 8, 2015
REFERRED TO COMMITTEE ON HEALTH, SEPTEMBER 8, 2015
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 children and youth,
providing for provider submissions and reimbursement rates.
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 Public Welfare Code, is amended by adding a section to
read:
Section 704.4. Provider Submissions and Reimbursement
Rates.--(a) Effective July 1, 2016, a provider shall submit
documentation of its costs of providing services in accordance
with this section.
(b) A provider shall submit documentation of its costs to
the department in the form of a cost report that is subject to
agreed upon procedures established by the department. The
department shall develop alternate procedures for providers who
lack actual cost data.
(c) The agreed upon procedures shall:
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(1) Include a requirement that a certified public accountant
attest to the validity and accuracy of a provider's cost report
prior to the submission of the cost report.
(2) Conform to the requirements of section 475(4)(A) of the
Social Security Act (49 Stat. 620, 42 U.S.C. § 675(4)(A)), 2 CFR
Pt. 200 (relating to uniform administrative requirements, cost
principles, and audit requirements for Federal awards), 45 CFR
1356.60 (relating to fiscal requirements) and 55 Pa. Code Ch.
3140 (relating to reimbursement requirements for county children
and youth social service programs).
(3) Include the following for use in determining allowable
costs:
(i) Reconciliation of the cost report to the provider trial
balance.
(ii) Cash disbursements for non-payroll and fringe benefits.
(iii) Payroll and fringe benefits.
(iv) Fixed assets.
(v) Census statistics.
(vi) Ancillary supporting documentation.
(d) A rate adjustment factor shall be used in calculating
total provider costs, costs under Title IV-E of the Social
Security Act (49 Stat. 620, 42 U.S.C. § 301 et seq.), State
reimbursement under section 704.1 and counties' share of costs.
The rate adjustment factor shall be applied to the costs
included in a provider's cost report to account for the twenty-
four month period between the year that costs are reported and
the year in which rates take effect. The rate adjustment factor
shall be published annually by the department in the
Pennsylvania Bulletin. The rate adjustment factor shall be
calculated by:
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(1) adding:
(i) the amount equivalent to seventy percent of the
employment cost index; and
(ii) the amount equivalent to thirty percent of the Consumer
Price Index; and
(2) multiplying the sum under clause (1) by two.
(e) The department shall develop and implement a training
curriculum for certified public accountants and provider and
county staff to ensure accurate completion of the required
agreed upon procedures.
(f) The department shall review cost reports submitted by
providers to determine compliance with requirements for Federal
funding and State reimbursement of allowable direct and indirect
costs incurred in the provision of out-of-home placement
services. The department shall develop, in conjunction with
providers and counties, a dispute resolution process to address
areas of disagreement with State review process findings.
(g) The department shall develop a plan to implement a
standardized time study process for provider staff to improve
accuracy and timeliness related to submission of claims for
Federal funds and elevated accountability for use of State
funds.
(h) The department shall convene a review committee
comprised of representatives from the department, county child
welfare agencies and providers to review the methodology used to
determine reimbursement for costs of provider services. The
review committee shall report its findings and recommendations
to the General Assembly annually for the first three years
following the effective date of this section and biennially
thereafter.
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(i) As used in this section:
"Agreed upon procedures" means the validation of costs
procedures that providers are required to follow in submitting
documentation of costs.
"Consumer Price Index" means the Consumer Price Index for All
Urban Consumers (CPI-U) for the Pennsylvania, New Jersey,
Delaware and Maryland area, officially reported by the United
States Department of Labor, Bureau of Labor Statistics.
"Employment cost index" means the most recent official
figures for the previous twelve-month period beginning July 1
and ending June 30 for the Employment Cost Index, all workers,
reported by the United States Department of Labor, Bureau of
Labor Statistics.
"Provider" means an entity licensed or certified to provide
twenty-four-hour out-of-home community-based or institutional
care and supervision of a child, with the care and supervision
being paid for or provided by a county using Federal or State
funds disbursed under this article.
Section 2. This act shall take effect immediately.
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