Section 240.1910  Establishment of Fixed Unit Rates

Rate methodologies and rates of payment for the Elderly Medicaid HCBS Waiver program are developed by the Department with consultation, oversight, and final approval by HFS, the State Medicaid agency.  During the Waiver's 5-year renewal process, the federal Centers for Medicare and Medicaid Services review the State's Elderly Waiver compliance, including rate sufficiency.

a)         The fixed unit rates will be reviewed annually, at a minimum, and adjustments will be made to conform to CCP's appropriation and to program service requirements and federal and State changes in statutes and rules affecting CCP.

b)         In establishing fixed unit rates of reimbursement, the Department will take into consideration the following:

1)         cost information provided by service providers;

2)         current market conditions and trend analyses; and

3)         CCP appropriation levels.

(Source:  Amended at 42 Ill. Reg. 20653, effective January 1, 2019)