53-6-406. Fiscal accountability for home and community-based services. (1) (a) A provider of personal assistance or attendant services or supports shall submit cost information to the department each year if the personal assistance or attendant services or supports are funded:
(i) as a state plan service;
(ii) through a medicaid state plan option available to the state under 42 U.S.C. 1396n(k); or
(iii) under a home and community-based services waiver for the elderly and disabled that is operated through a division of the department that administers long-term care services for senior citizens and individuals with physical disabilities.
(b) The information provided to the department must reflect costs incurred during the provider's most recent fiscal year.
(2) The department shall develop a standardized format for the information that includes the recognized expenditures incurred by providers.
(3) The department shall analyze cost information submitted by providers to determine at a minimum:
(a) the reasonable cost of providing the home and community-based services detailed in the report;
(b) the percentage of a provider's cost represented by payment of wages and benefits for direct-care employees; and
(c) the level of profit or loss that each provider incurred in delivering the service. The profit or loss must be determined by comparing the recognized cost of providing the service with the medicaid reimbursement provided for the same service.
(4) The department may adopt rules requiring other providers of medicaid home and community-based services that are provided in a person's home to submit the cost information required under this section.
History: En. Sec. 2, Ch. 324, L. 2015.