OVERVIEW: Amends
405 IAC 1-12-1 to clarify policy language regarding payment for services rendered by intermediate care facilities for individuals with intellectual disabilities (ICFs/IID) and community residential facilities for the developmentally disabled (CRFs/DD). Amends
405 IAC 1-12-2 to add a definition for the department head position. Amends
405 IAC 1-12-3 to clarify provider responsibility to substantiate that their costs are related to patient care. Amends
405 IAC 1-12-4 to clarify the penalty for untimely cost report filings. Amends
405 IAC 1-12-5 to add a penalty for untimely filing of the Checklist of Management Representations. Amends
405 IAC 1-12-7 to clarify the criteria for excluding a provider from the average allowable cost of the median patient day computations. Amends
405 IAC 1-12-19 to update and clarify language. Amends
405 IAC 1-12-20 to update language. Amends
405 IAC 1-12-21 to revise the reimbursement rate for Comprehensive Rehabilitative Management Needs Facilities (CRMNF) pursuant with state law. Amends
405 IAC 1-14.6-1 to clarify policy language regarding payment for services rendered to members by nursing facilities. Amends
405 IAC 1-14.6-2 to update definitions to reflect the change from the
Resource Utilization Group, version III (RUG-III), to RUG-IV, update the Minimum Data Set resident assessment (MDS), version 2.0 to MDS version 3.0, and to clarify and add several definitions. Amends
405 IAC 1-14.6-3 to clarify the information required on the Medicaid cost report form, to require financial records or supporting documentation to be made available to the office, to add penalty for failure to submit requested information, and to clarify compliance review scheduling procedures and clarify provider responsibility to substantiate that their costs are related to patient care. Amends
405 IAC 1-14.6-4 to clarify the information required by providers with their annual cost report submission and to make other changes as a result of the change to RUG-IV. Amends
405 IAC 1-14.6-6 to update and clarify language regarding rate reviews. Amends
405 IAC 1-14.6-7 to add the Case Mix Index (CMI) table for RUG-IV and to make other changes as a result of the change to RUG-IV. Amends
405 IAC 1-14.6-9 to clarify the calendar quarters utilized in determining a facility's CMI. Amends
405 IAC 1-14.6-10 to clarify certain costs as not allowable. Amends
405 IAC 1-14.6-11 to clarify the reporting of costs incurred by parties defined by the rule to be related to the Medicaid certified nursing facilities. Amends
405 IAC 1-14.6-12 to
clarify what costs are included in the fair rental value allowance. Amends
405 IAC 1-14.6-21 to clarify that changes to the allocation of reported costs due to prior period audit findings are authorized by OMPP. Amends
405 IAC 1-14.6-22 to update and clarify language regarding MDS review processes. Amends
405 IAC 1-14.6-24 to clarify how the Quality Assessment Fee (QAF) is determined. Amends
405 IAC 1-15-1 to clarify and update MDS electronic transmission requirements for nursing facilities. Amends
405 IAC 1-15-2 to modify the Medicaid rule for the electronic transmission of the MDS to reflect the change from RUG-III to RUG-IV and MDS 2.0 to MDS 3.0. Amends
405 IAC 1-15-4 to clarify scope of review by OMPP of nursing facility MDS resident assessment data and to reflect the change from RUG-III to RUG-IV. Amends
405 IAC 1-15-5 to clarify scope of review of MDS resident assessments. Repeals
405 IAC 1-14.5,
405 IAC 1-15-3, and
405 IAC 1-15-6 as obsolete. Effective 30 days after filing with the Publisher. Statutory authority:
IC 12-15-1-10;
IC 12-15-21-2.
