For Fiscal Year 2011: (July 1, 2010 - June 30, 2011): The facility rate effective 7-1-2010 to 7-31-2010 was $64.11. The rate effective 8-1-2010 to 6-30-2011 was $63.11. This was due to a 2% rate cut effective 8-1-2010. Facilities are required by the ADHC Payment Methodology Rule published October 20, 2008, to spend no less than 90% of the direct care component in the rate. If a facility fails to expend the direct care expenditure floor, the department will cost settle their direct care.
For Fiscal Year 2012: (July 1, 2011 - June 30, 2012): Effective July 1, 2011 the Department of Health will implement a change in how Adult Day Health Care (ADHC) services are reimbursed by the Medicaid Program. ADHC providers will be reimbursed at a quarter hour (15-minute) rate of pay instead of a "per diem" or daily rate. The rate of pay will be $2.44 plus the provider specific transportation rate (per 15 minute unit). A new provider will receive the "Median Quarter Hour Transportation Cost" of $.20 per quarter hour, therefore their rate will be $2.44 + $.20 = $2.64 per quarter hour unit. Effective July 1, 2011, facilities are required by the ADHC Payment Methodology Emergency Rule published June 20, 2011, to spend no less than 70% of the direct care component in the rate. If a facility fails to expend the direct care expenditure floor, the department will cost settle their direct care.
If additional information is required, please contact Rate and Audit Unit at (225) 342-6116.