Review the latest Medicare/Medicaid Updates.

01-01-2023 Pennsylvania, Managed Care Minimum Payment Rates _ State Directed Payment

On December 30, 2022 the CMS approved a state-directed payment authorizing minimum payment rates to nursing facilities in the CHC managed care LTSS program. The minimum payment rates are effective with dates of services January 1, 2023 and later. The minimum payment rates consist of three parts: the approved State Plan rate per diem as determined in accordance with State Plan attachment 4.19 D; a uniform rate per diem by provider class; and a facility specific rate per diem by provider class. For each nursing facility, the sum of the three amounts equals the minimum rate at which a CHC-MCO must contract with the facility.

Minimum Payment Rates