Library: Policy

317:30-5-664.12. Determination of Health Center PPS rate

Revised 9-1-15

(a) Methodology.  The methodology for establishing each facility's PPS rate is found in Attachment 4.19 B of the OHCA's State Plan, as amended effective January 1, 2001, and incorporated herein by reference.

(b) Scope of service adjustment.  If a Center significantly changes its scope of services, the Center may request in writing that new baseline encounter rates be determined.  Adjustments to encounter rates are made if it is determined that a significant change in the scope-of-service has occurred which impacts the base rate, as indicated within the State Plan. If there is a change in scope-of-service, it is the responsibility of the FQHC to request OHCA to review services that have had a change to the scope-of-service.  The OHCA may initiate a rate adjustment in accordance with procedures in the State Plan, based on audited financial statements or cost reports, if the scope of services has been modified or would otherwise result in a change to the Center's current rate.  If a new rate is set, the rate will be effective on the date the change in scope-of-service was implemented.