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payments may be withheld until the center submits auditable records. The provider shall be responsible for costs incurred by the department’s auditors when additional services or procedures are performed to complete the audit.

H.Vendor payments may also be withheld under the following conditions:

1.a center fails to submit corrective action plans in response to financial and compliance audit findings within 15 days after receiving the notification letter from the department; or
2.a center fails to respond satisfactorily to the department’s request for information within 15 days after receiving the department’s notification letter.

I.The provider shall cooperate with the audit process by:

1.promptly providing all documents needed for review;
2.providing adequate space for uninterrupted review of records;
3.making persons responsible for center records and cost report preparation available during the audit;
4.arranging for all pertinent personnel to attend the closing conference;
5.insuring that complete information is maintained in client’s records;
6.developing a plan of correction for areas of noncompliance with state and federal regulations immediately after the exit conference time limit of 30 days.

AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Office of Aging and Adult Services, LR 34:2169 (October 2008).

§2913.Exclusions from the Database

A.The following providers shall be excluded from the database used to calculate the rates:

1.providers with disclaimed audits; and
2.providers with cost reports for periods other than a 12-month period.

AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Office of Aging and Adult Services, LR 34:2170 (October 2008).

§2915.Provider Reimbursement

A.Cost Determination Definitions

Adjustment Factor—computed by dividing the value of the index for December of the year preceding the rate year by the value of the index one year earlier (December of the second preceding year).
Base Rate—calculated in accordance with §2915.B.5, plus any base rate adjustments granted in accordance with §2915.B.7 which are in effect at the time of calculation of new rates or adjustments.
Base Rate Components—the base rate is the summation of the following:
a.direct care;
b.care related costs;
c.administrative and operating costs; and
d.property costs.
Indices
a.CPI, All Items—the Consumer Price Index for All Urban Consumers-South Region (All Items line) as published by the United States Department of Labor.
b.CPI, Medical Services—the Consumer Price Index for All Urban Consumers-South Region (Medical Services line) as published by the United States Department of Labor.

B.Rate Determination

1.The base rate is calculated based on the most recent audited or desk reviewed cost for all ADHC providers filing acceptable full year cost reports.
2.Audited and desk reviewed costs for each component are ranked by center to determine the value of each component at the median.
3.The median costs for each component are multiplied in accordance with §2915.B.4 then by the appropriate economic adjustment factors for each successive year to determine base rate components. For subsequent years, the components thus computed become the base rate components to be multiplied by the appropriate economic adjustment factors, unless they are adjusted as provided in §2915.B.7 below. Application of an inflationary adjustment to reimbursement rates in non-rebasing years shall apply only when the state legislature allocates funds for this purpose. The inflationary adjustment shall be made prorating allocated funds based on the weight of the rate components.
4.The inflated median shall be increased to establish the base rate median component as follows.
a.The inflated direct care median shall be multiplied times 115 percent to establish the direct care base rate component.
b.The inflated care related median shall be multiplied times 105 percent to establish the care related base rate component.
c.The administrative and operating median shall be multiplied times 105 percent to establish the administrative and operating base rate component.
5.At least every three years, audited and desk reviewed cost report items will be compared to the rate components calculated for the cost report year to insure that the rates remain reasonably related to costs.
6.Formulae. Each median cost component shall be calculated as follows.
a.Direct Care Cost Component. Direct care per diem costs from all acceptable full year cost reports, except those for which an audit disclaimer has been issued, shall be arrayed from lowest to highest. The cost at the midpoint of the array shall be the median cost. Should there be an even number of arrayed cost, an average of the two midpoint centers shall be the median cost. The median cost shall be trended forward using the Consumer Price Index for Medical Services. The direct care rate component shall be set at 115 percent of the inflated median.
i.For dates of service on or after February 9, 2007, and extending until the ADHC rate is rebased using a cost report that begins after 7/1/2007, the center-specific direct care rate will be increased by $1.11 to include a direct care service worker wage enhancement. It is the intent that this wage enhancement be paid to the direct care service workers.
b.Care Related Cost Component. Care related per diem costs from all acceptable full year cost reports, except

Louisiana Register   Vol. 34, No. 10   October 20, 2008

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