Section 29-4907. REIMBURSEMENT

 

4907.1An interim rate shall be developed for reimbursement of rehab services based on unaudited costs as reported by CFSA. The final rate paid to CFSA shall not exceed the actual cost incurred by CFSA in providing services to the target population.

 

4907.2The interim rate for rehab services, including the District and federal share shall be as follows:

 

(a)Therapeutic Foster Care - $ 61.64 per diem

 

(b)Youth Group Home - $ 87.25 per diem

 

4907.3The client specific interim rate set forth in § 4907.2 shall be inclusive of all services authorized pursuant to this Chapter, and shall be paid only once per day regardless of the number of individual services provided during the day.

 

4907.4If, after an audit, an adjustment is made to CFSA's reported costs, all claims paid during the audit period shall be adjusted to conform with the actual cost of CFSA providing services to the target population.

 

4907.5CFSA shall agree to accept as payment in full the amount determined by MAA as reimbursement for authorized services provided to clients. Providers shall not bill the client or any member of the client's family for rehab services.

 

4907.6CFSA shall bill any and all known third-party payors prior to billing the Medicaid Program.

 

4907.7CFSA shall be responsible for paying the District's share or the local match for rehab services provided by CFSA or its subcontractors. CFSA shall certify, on an annual basis, that it has expended non-federal public funds in an amount equal to the District's share. The annual certification shall be made in writing in a manner prescribed by the Department of Health.

 

source

Emergency Rulemaking published at 48 DCR 8872 (September 21, 2001) [EXPIRED]; as amended by Final Rulemaking published at 49 DCR 247 (January 11, 2002).