| (a) Payment rate determination. Payment rates for the
Prescribed Pediatric Extended Care Centers program are developed based
on payment rates determined for other programs that provide similar
services. If payment rates are not available from other programs providing
similar services, payment rates are determined using a pro forma analysis
in accordance with §355.105(h) of this chapter (relating to General
Reporting and Documentation Requirements, Methods, and Procedures).
(b) Related information. The information in §355.101
of this chapter (relating to Introduction) and §355.105(g) of
this chapter applies to this section.
(c) Reporting of cost. To gather adequate financial
and statistical information upon which to base reimbursement, the
Health and Human Services Commission (HHSC) may require a contracted
provider to submit a cost report for any service provided through
the Prescribed Pediatric Extended Care Centers program.
(1) If HHSC requires the provider to submit a cost
report, the provider must follow the cost reporting guidelines in §355.105
of this chapter and the guidelines for determining whether a cost
is allowable or unallowable in §355.102 of this chapter (relating
to General Principles of Allowable and Unallowable Costs) and §355.103
of this chapter (relating to Specifications for Allowable and Unallowable
Costs).
(2) A provider is excused from the requirement to submit
a cost report if the provider meets one or more of the conditions
in §355.105(b)(4)(D) of this chapter.
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