Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.10 - MEDICAID ENHANCED PLAN BENEFITS › SUB-PART: CHILDREN'S DEVELOPMENTAL DISABILITIES (DD) HOME AND COMMUNITY-BASED SERVICES (HCBS) STATE PLAN OPTION › Section 16.03.10.624 - ICF/IID: CAPPED COST

Current through August 31, 2023
Beginning October 1, 1996, this cost area includes all
				  allowable costs except those specifically identified as property costs in
				  Section 623 of these
				  rules and exempt costs or excluded costs in Section
				  627 or
				  628 of these rules. This Section
				  defines items and procedures to be followed in determining allowable and exempt
				  costs and provides the procedures for extracting cost data from historical cost
				  reports, applying a cost forecasting market basket to project cost forward,
				  procedures to be followed to project costs forward, and procedures for
				  computing the median of the range of costs and the ICF/IID cap.
				  (3-17-22)
01.
Costs Subject to
				the Cap
. Items subject to the cap include all allowable costs except
				property costs identified in Section
				623 of these rules and exempt costs
				or excluded costs identified in Section
				627 or
				628 of these rules. Property costs
				related to a home office are administrative costs, will not be reported as
				property costs, and are subject to the cap. (3-17-22)
02.
Per Diem Costs
. Costs to be
				included in this category will be divided by the total participant days for the
				facility for the cost reporting period to arrive at allowable per diem costs.
				If costs for services provided some or all non-Medicaid residents are not
				included in the total costs submitted, the provider must determine the costs
				and combine them with the submitted costs in order that a total per diem cost
				for that facility can be determined both for both the purposes of determining
				the ICF/IID cap and of computing final reimbursement. (3-17-22)
03.
Cost Data to Determine the
				Cap
. Cost data to be used to determine the cap for ICF/IID facilities
				will be taken from each provider's most recent final cost report available
				sixty (60) days before the beginning of the period for which the cap is being
				set. Cost reports are final when the final audit report is issued, or earlier
				if the Department informs the facility the report is final for rate setting
				purposes. The selected final cost report will be used to establish the
				facility's prospective reimbursement rate. However, the final cost reports
				covering a period of less than twelve (12) months will be included in the data
				for determining the cap at the option of the Department. (3-17-22)
04.
Projection
. Per diem
				allowable costs will be inflated forward using a cost forecasting market basket
				and forecasting indices according to the same table as used for free standing
				facilities. (3-17-22)
a. The projection
				method used in Section
				624 of these rules to set the cap
				will also be used to set non property portions of the prospective rate that are
				not subject to the cap. (3-17-22)
b. Forecasting indices as developed by Data
				Resources, Incorporated, will be used unless they are unavailable. In such
				case, indices supplied by some other nationally recognized forecaster will be
				used. (3-17-22)