How do states claim 75 percent Federal Financial Participation (FFP) for Preadmission screening and resident review (PASRR) activities?

The Code of Federal Regulations (CFR) give states the authority to claim FFP for administrative activities associated with the PASRR program included in their State Plan at 42 CFR 433.15. Eligible PASRR activities conducted by the state may be claimed at 75 percent.

Since only a state Medicaid agency (SMA) may submit a State Plan, only the SMA may submit reimbursement claims to the Centers for Medicare & Medicaid Services (CMS) for FFP. Lines 10 and 11 of Form CMS-64 are used to claim the enhanced 75 percent match rate for PASRR-related activities. A state should use line 10 to claim its “Preadmission Screenings Costs,” i.e. PASRR activities that happen before admission to a nursing facility. A state should use Line 11 for “Resident Review Activities Costs,” i.e. resident evaluations triggered by a significant change in condition that affects an individual's disability-specific needs. Although the match rate for lines 10 and 11 is 75 percent, accurate allocation of costs across these two categories is important.

States should contact the financial management department in their SMA for more information on how to allocate PASRR costs shared across Preadmission Screening (line 10) and Resident Review Activities (line 11). States input the amount of money spent for line 10 and line 11 in Column A (Total Computable) of Form CMS-64 . The system will automatically calculate the 75 percent match rate for these expenditures.

The SMA is responsible for reimbursing the state mental health authority (SMHA) and state intellectual disability authority (SIDA) for PASRR activities.  The process for reimbursement and the requirements for documenting time spent on PASRR activities can be established through the interagency agreements required of the state PASRR programs at 42 CFR 431.621. The mechanism for the transfer of funds can take a variety of forms, such as the actual transfer of money from one account to another, or use of a rolling credit/debit sheet maintained among the participating agencies.

The CMS PASRR Technical Assistance Center is available to provide technical assistance on questions about how to calculate time spent on PASRR activities.