| cancelled by subsection (e) of this section,
new contracts will not be permitted to be enrolled.
(h) Attendant Compensation Report submittal requirements.
(1) Annual Attendant Compensation Report. Providers
must file Attendant Compensation Reports as follows. All participating
contracted providers will provide HHSC Rate Analysis, in a method
specified by HHSC Rate Analysis, an annual Attendant Compensation
Report reflecting the activities of the provider while delivering
contracted services from the first day of the rate year through the
last day of the rate year. This report must be submitted for each
participating contract if the provider requested participation individually
for each contract; or, if the provider requested participation as
a group, the report must be submitted as a single aggregate report
covering all contracts participating at the end of the rate year within
one program of the provider. A participating contract that has been
terminated in accordance with subsection (v) of this section or that
has undergone a contract assignment in accordance with subsection
(w) of this section will be considered to have participated on an
individual basis for compliance with reporting requirements for the
owner prior to the termination or contract assignment. This report
will be used as the basis for determining compliance with the spending
requirements and recoupment amounts as described in subsection (s)
of this section. Contracted providers failing to submit an acceptable
annual Attendant Compensation Report within 60 days of the end of
the rate year will be placed on vendor hold until such time as an
acceptable report is received and processed by HHSC Rate Analysis.
(A) When a participating provider changes ownership
through a contract assignment, the prior owner must submit an Attendant
Compensation Report covering the period from the beginning of the
rate year to the effective date of the contract assignment as determined
by HHSC, or its designee. This report will be used as the basis for
determining any recoupment amounts as described in subsection (s)
of this section. The new owner will be required to submit an Attendant
Compensation Report covering the period from the day after the date
recognized by HHSC, or its designee, as the contract-assignment effective
date to the end of the rate year.
(B) Participating providers whose contracts are terminated
voluntarily or involuntarily must submit an Attendant Compensation
Report covering the period from the beginning of the rate year to
the date recognized by HHSC or its designee as the contract termination
date. This report will be used as the basis for determining recoupment
as described in subsection (s) of this section.
(C) Participating providers who voluntarily withdraw
from participation, as described in subsection (x) of this section,
must submit an Attendant Compensation Report within 60 days from the
date of withdrawal as determined by HHSC. This report must cover the
period from the beginning of the rate year through the date of withdrawal
as determined by HHSC and will be used as the basis for determining
any recoupment amounts as described in subsection (s) of this section.
(D) Participating providers whose cost report year,
as defined in §355.105(b)(5) of this subchapter, coincides with
the state of Texas fiscal year, are exempt from the requirement to
submit a separate Attendant Compensation Report. For these contracts,
their cost report will be considered their Attendant Compensation
Report.
(2) Cost reports as described in §355.105(b) -
(c) of this subchapter will serve as the Attendant Compensation Report
with the following exceptions:
(A) When a participating provider changes ownership
through a contract assignment or change of ownership, the previous
owner must submit an Attendant Compensation Report covering the period
from the beginning of the provider's cost reporting period to the
date recognized by HHSC, or its designee, as the contract-assignment
or ownership-change effective date. This report will be used as the
basis for determining any recoupment amounts as described in subsection
(s) of this section. The new owner must submit a cost report covering
the period from the day after the date recognized by HHSC or its designee
as the contract-assignment or ownership-change effective date to the
end of the provider's fiscal year.
(B) When one or more contracts or, for the ICF/IID,
HCS and TxHmL programs, component codes of a participating provider
are terminated, either voluntarily or involuntarily, the provider
must submit an Attendant Compensation Report for the terminated contract(s)
or component code(s) covering the period from the beginning of the
provider's cost reporting period to the date recognized by HHSC, or
its designee, as the contract or component code termination date.
This report will be used as the basis for determining any recoupment
amounts as described in subsection (s) of this section.
(C) When one or more contracts or, for the ICF/IID,
HCS and TxHmL programs, component codes of a participating provider
are voluntarily withdrawn from participation as per subsection (x)
of this section, the provider must submit an Attendant Compensation
Report within 60 days of the date of withdrawal as determined by HHSC,
covering the period from the beginning of the provider's cost reporting
period to the date of withdrawal as determined by HHSC. This report
will be used as the basis for determining any recoupment amounts as
described in subsection (s) of this section. These providers must
still submit a cost report covering the entire cost reporting period.
The cost report will not be used for determining any recoupment amounts.
(D) For new contracts as defined in subsection (g)
of this section, the cost reporting period will begin with the effective
date of participation in the enhancement.
(E) Existing providers who become participants in the
enhancement as a result of the open enrollment process described in
subsection (e) of this section on any day other than the first day
of their fiscal year must submit an Attendant Compensation Report
with a reporting period that begins on their first day of participation
in the enhancement and ends on the last day of the provider's fiscal
year. This report will be used as the basis for determining any recoupment
amounts as described in subsection (s) of this section. These providers
must still submit a cost report covering the entire cost reporting
period. The cost report will not be used for determining any recoupment
amounts.
(F) A participating provider that is required to submit
a cost report or Attendant Compensation Report under this paragraph
will be excused from the requirement to submit a report if the provider
did not provide any billable attendant services to HHSC recipients
during the reporting period.
(3) Other reports. HHSC may require other reports from
all contracts as needed.
(4) Vendor hold. HHSC, or its designee, will place
on hold the vendor payments for any participating provider who does
not submit a timely report as described in paragraph (1) of this subsection
completed in accordance with all applicable rules and instructions.
This vendor hold will remain in effect until HHSC Rate Analysis receives
an acceptable report.
(A) Participating contracts or, for the ICF/IID, HCS
and TxHmL programs, component codes that do not submit an acceptable
report completed in accordance with all applicable rules and instructions
within 60 days of the due dates described in this subsection or, for
cost reports, the due dates described in §355.105(b) of this
subchapter will become nonparticipants retroactive to the first day
of the reporting period in question and will be subject to an immediate
recoupment of funds related to participation paid to the contractor
for services provided during the reporting period in question. These
contracts or component codes will remain nonparticipants and recouped
funds will not be restored until they submit an acceptable report
and repay to HHSC, or its designee, funds identified for recoupment
from subsection (s) of this section. If an acceptable report is not
received within 365 days of the due date, the recoupment will become
permanent and, if all funds associated with participation during the
reporting period in question have been recouped by HHSC, or its designee,
the vendor hold associated with the report will be released.
(B) Participating contracts or, for the ICF/IID, HCS
and TxHmL programs, component codes that have terminated or undergone
a contract assignment or ownership-change from one legal entity to
a different legal entity and do not submit an acceptable report completed
in accordance with all applicable rules and instructions within 60
days of the contract assignment, ownership-change or termination effective
date will become nonparticipants retroactive to the first day of the
reporting period in question. These contracts or component codes will
remain nonparticipants and recouped funds will not be restored until
they submit an acceptable report and repay to HHSC, or its designee,
funds identified for recoupment under subsection (s) of this section.
If an acceptable report is not received within 365 days of the contract
assignment, ownership-change or termination effective date, the recoupment
will become permanent and, if all funds associated with participation
during the reporting period in question have been recouped by HHSC,
or its designee, the vendor hold associated with the report will be
released.
(5) Provider-initiated amended Attendant Compensation
Reports and cost reports functioning as Attendant Compensation Reports.
Reports must be received before the date the provider is notified
of compliance with spending requirements for the report in question
in accordance with subsection (s) of this section.
(i) Report contents. Each Attendant Compensation Report
and cost report functioning as an Attendant Compensation Report will
include any information required by HHSC to implement this attendant
compensation rate enhancement.
(j) Completion of compensation reports. All Attendant
Compensation Reports and cost reports functioning as Attendant Compensation
Reports must be completed in accordance with the provisions of §§355.102
- 355.105 of this subchapter (relating to General Principles of Allowable
and Unallowable Costs; Specifications for Allowable and Unallowable
Costs; Revenues; and General Reporting and Documentation Requirements,
Methods, and Procedures) and may be reviewed or audited in accordance
with §355.106 of this subchapter (relating to Basic Objectives
and Criteria for Audit and Desk Review of Cost Reports). All Attendant
Compensation Reports and cost reports functioning as Attendant Compensation
Reports must be completed by preparers who have attended the required
cost report training for the applicable program under §355.102(d)
of this subchapter. For the ICF/IID program, cost reports functioning
as Attendant Compensation Reports must also be completed in accordance
with the provisions of §355.456 of this chapter (relating to
Reimbursement Methodology). For the HCS and TxHmL programs, cost reports
functioning as Attendant Compensation Reports must also be completed
in accordance with the provisions of §355.722 of this chapter
(relating to Reporting Costs by Home and Community-based Services
(HCS) and Texas Home Living (TxHmL) Providers).
(k) Enrollment. Providers choosing to participate in
the attendant compensation rate enhancement must submit to HHSC a
signed enrollment contract amendment as described in subsection (f)
of this section. Participation is determined separately for each program
specified in subsection (a) of this section, except that for providers
delivering both RC and CBA AL/RC services in the same facility, participation
includes both the RC and CBA AL/RC programs and for providers delivering
both HCS and TxHmL services, participation includes both the HCS and
TxHmL programs. For PHC, participation is also determined separately
for priority and nonpriority services. For ICF/IID, participation
is also determined separately for residential services and day habilitation
services. For HCS and TxHmL, participation is also determined separately
for the non-day habilitation services category and the day habilitation
services category as defined in subsection (f)(2)(B) of this section.
Participation will remain in effect, subject to availability of funds,
until the provider notifies HHSC, in accordance with subsection (x)
of this section, that it no longer wishes to participate or until
HHSC excludes the contract from participation for reasons outlined
in subsection (u) of this section. Contracts or component codes voluntarily
withdrawing from participation will have their participation end effective
with the date of withdrawal as determined by HHSC. Contracts or components
codes excluded from participation will have their participation end
effective on the date determined by HHSC.
(l) Determination of attendant compensation rate component
for nonparticipating contracts.
(1) For the PHC; DAHS; RC; CLASS--DSA; CBA--HCSS; DBMD;
and CBA--AL/RC programs, HHSC will calculate an attendant compensation
rate component for nonparticipating contracts as follows.
(A) Determine for each contract included in the cost
report database used in determination of rates in effect on September
1, 1999, the attendant compensation cost center from subsection (c)
of this section.
(B) Adjust the cost center data from subparagraph (A)
of this paragraph in order to account for inflation utilizing the
inflation factors used in the determination of the September 1, 1999
rates.
Cont'd... |
