Maintenance Rate - Therapeutic Foster Care 623-05-20-35

(Revised 4/25/16 ML #3469)

View Archives

PI 17-05

 

 

 

ND Therapeutic Providers:

1. PATH-ND (Professional Association of Treatment Homes)
   1202 Westrac Dr S, Suite 100
   Fargo, ND 58103
   Phone: 701-280-8545
   
   Billing Address:
   PATH ND
   Rice Creek Professional Building
   5985 Rice Creek Pkwy, Suite 202
   Shoreview, MN 55126

PATH Maintenance Rates (July 1, 2015) Payments are made using the daily rate times the number of days in care.

 

LEVEL OF CARE OFFERED BY THE THERAPEUTIC PROVIDER	DAILY RATE	MONTHLY RATE (30 days)
Therapeutic Treatment PATH provides case management	$108.18	$3,245.40
Step Down (Regular PATH) PATH provides case management	$66.23	$1,986.90
County (Flow Through) Sibling placement - Custodian provides case management to the child.	Family Foster Care Maintenance Rate (Based on Child Age)	Varied

 

Payments to PATH should not be authorized until a billing statement has been received for the appropriate month.  PATH and the Department of Human Services shall review PATH foster care maintenance rates quarterly.  Therefore it is possible that the daily rate could change on a quarterly basis.

 

The custodian and the child's team will evaluate the child’s progress to determine the appropriate level of care. If placement in the PATH Step Down option is appropriate, the custodian and PATH will sign the needed documentation at the Child & Family Team meeting. The custodial case manager will be responsible to notify the county eligibility worker of any changes.

 

BILLING:

The PATH billing office will send a separate bill for each child monthly. The county should receive the bill on or around the 12th of the month. Eligibility workers must wait for the bill prior to authorizing payments. The payment amount is not automatically calculated by the payment system and will require manual input. The bill should be kept in the foster care eligibility file.

• If PATH has a placement and also has an overpayment. Eligibility must wait to authorize the standard maintenance payment until the last week of that month, after the last supplemental check write and prior to the standard check write in an effort to auto-recoup the provider overpayment.

PAYMENTS

Therapeutic and Step-Down/PATH Regular Foster Care:

The amount billed is based on the number of days in placement, not to exceed the number of days in the month. Reimbursement of overlapping days of placement from one therapeutic provider to another is not allowed.

• Example: A child changes placement from one therapeutic home to another on the 3rd of the month, only one therapeutic provider can be reimbursed for the 3rd.
• Secondary placements in a therapeutic home when a child is in a primary therapeutic placement are not reimbursable.
• The monthly bill from the agency must provide an itemization of each placement with each provider. If the bill contains multiple providers, each provider must have an approved placement in FRAME and payment authorization must be made to each provider based on the billed dates and amount specific to that provider. Do not authorize a lump sum payment to only one provider if multiple placements exist during the billing cycle.

Irregular payments: Only two irregular payment options are allowed for Therapeutic and Step-Down/PATH Regular Foster Care:

• Travel for foster parents to transport to a school in which the youth is enrolled at the time of placement, payment code 53, and
• If the foster child has their own child (not in public agency custody) ‘parent/infant’ payment, code 71.

NOTE: CCWIPS will only allow irregular payment authorization for codes 53 and 71 for a licensed therapeutic provider.

County (Flow Through) Placements:

The county (flow through) rate is billed by PATH to the county monthly. The rate billed is based on the ND family foster care maintenance rate specific to the child’s age.

 

Irregular Payments for county (flow through) placements are allowed and the same policy applies to county (flow through) placements in a therapeutic home as it does for county family foster care placements. The rate does not include irregular payments and PATH will not bill for approved irregular expenses. The reimbursement of receipts is handled through the county as follows:

1. All irregular payments must be approved as set forth in policy and should be documented in the Child and Family Team Meeting notes.
2. Case manager must provide the eligibility worker with documentation of the approved irregular expenses.
3. The receipts are emailed/faxed/mailed by the PATH foster care provider to a designated PATH worker and/or county case manager.
4. The county case manager should provide the eligibility worker with a copy of the receipts and the PATH worker will provide the PATH billing office with a copy of the receipts (unless other arrangements have been made between the PATH worker and the County case managers in regard to distribution of the receipts).
5. PATH DOES NOT bill the irregular expenses for PATH county (flow through) placements to the county. They will only bill the standard rate for care. It is the responsibility of the county to reimburse the irregular payments to PATH. In turn, PATH will reimburse the foster parents the amount of payment received from the county to cover the irregular expenses; hence “flow through”.
6. If PATH’s billing office has questions regarding the amount received over and above the standard foster care rate, the county worker will be contacted for clarification.

How to Authorize the Irregular Payments for PATH County (flow through) placements in CCWIPS:

• The amount of the receipt(s) must be added to the standard maintenance payment amount.
• CCWIPS allows only two irregular payment codes to PATH providers - codes 53 and 71. Therefore, irregular payments will require a payment adjustment of the monthly standard payment.
• Irregular payments for code 53 - transportation to school and code 71 – parent/infant care, must be authorized separately and on the irregular payment screen.

Refer to CCWIPS User manual for technical assistance related to entering PATH-ND foster care payments on the CCWIPS system.

 

Medicaid eligibility must be determined prior to referral of a child to PATH-ND. The treatment (rehabilitation) amount may be paid by Title XIX, or some other resource. Rehabilitation costs CANNOT BE PAID THROUGH FOSTER CARE.