TOPIC: FEDERAL REIMBURSEMENT

This webinar will review findings of 2018 National Report and consider what they reveal about how states finance and operate PASRR programs.

A Cost Allocation Plan (CAP) is a narrative description of the procedures that a state will use in identifying, measuring, and allocating costs that it incurs in supporting programs it administers or supervises. In the case of PASRR, the State Medicaid Agency (SMA) is responsible for developing a CAP as part of the requirements for claiming the enhanced 75% match for PASRR-related activities. These requirements are outlined in further detail in § 45 CFR 95 Subpart E. Additional guidance may be given by the Centers for Medicare & Medicaid Services (CMS) Regional Office or contact the PASRR Technical Assistance Center.

According to §1903(a)(2)(C) of the Social Security Act and 42 CFR 433.15(b)(9), activities that can be clearly tied to the administration of PASRR, and in accordance with an approved cost allocation plan, may be claimed at the enhanced 75% match.

Federal regulations give states the authority to claim FFP for administrative activates associated with the PASRR program included in their State Plan at Part §433.15(a)(9) of the CFR. Eligible (PASRR) activities conducted by the State may be claimed at 75%.

To understand what PASRR activities cannot be claimed at the 75% Federal Financial Participation (FFP) match, one must first be clear on what activities are eligible for FFP.

"States may claim the enhanced 75% match rate for PASRR-related activities by completing the Form CMS-64. Specifically, a state should use line 10 to claim its “Preadmission Screenings Costs,” i.e. PASRR activities that happen before admission into 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.