fb88Care Rate System Reform

Our Goal

To provide a clear and transparent process for fb88Care rate determinations, with opportunities for robust participation from all interested stakeholders.Ìý

We will be updating this page with important dates and progress made on past, current, and future rate determination work. Please check in often, as this site is a work in progress.Ìý

Public Notice of Initiation

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    Phase 1. Research and Planning

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    Phase 2. Project Kickoff

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    Phase 3. Provider Survey

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    Phase 4. Rate Model Development

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    Phase 5. Public Comment

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    Phase 6. Finalize Rate

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    Phase 7. Begin Rulemaking

fb88Care Rate Determination ScheduleÌý

As mandated, the Department must annually develop a schedule of rate determination in consultation with the Technical Advisory Panel (TAP).ÌýThe Department must then post the proposed rate determination schedule on its publicly accessible website, provide an opportunity for the public to review and comment on the rate determination schedule, and make available a summary of these comments on its publicly accessible website.Ìý

The Department has posted the presentation to the TAP, which we encourage interested parties to review as it contains additional context and rationale pertaining to the proposed schedule.

Rate Determination Schedule

Virtual Rate Determination Proposed Schedule Public ForumÌý

The Department is held a virtual public forum for interested parties to comment on the proposed schedule.

Public Comments

  • Comments were submitted through November 9, 2022
  • A summary of comments can be found here (PDF)
  • The Department will post its final schedule for rate determinations to be initiated through calendar year 2023 in December 2022.
Rate Determination Initiation Notices Sent Out to Date

Section 23 - Developmental and Behavioral Clinic Services:ÌýNew Service Foster Care Comprehensive Health Assessment 

fb88Care is currently updating fb88Care Benefits Manual, Chapter II, Section 23 Foster Care Comprehensive Health Assessment reimbursement methodology as part of ourÌýrate reform initiatives.

Background

In 2019, DHHS and fb88Care launched aÌýÌýto serve as the basis to inform policy making and improve members’ health and the program’s sustainability by comprehensively evaluating rates and promoting high-value services.ÌýÌý

The evaluation found that many rates were outdated and inconsistent, some with no known basis or methodology. It also found significant inconsistencies inÌýÌýmethodology and timelines for rate adjustments between services.Ìý

The evaluation made a number of recommendations that were ultimately codified in law inÌý, which was enacted in 2022.ÌýÌýSpecifically, Ch. 639:

  1. Sets a schedule for regular rate review and adjustment.
  2. Ensures review of relevant state and national data to inform rate amounts and payment models, with emphasis on models that promote high value services by connecting reimbursement to performance.
  3. Formalizes a clear and transparent process for rate determination via public notice, presentation and comments (as well as public response to comments) on proposed rates.
  4. Establishes a rate system sub-committee to the fb88Care Advisory Committee (MAC).
  5. Establishes the fb88Care Rate Reform ExpertÌýÌýTechnical Advisory Panel (TAP) for consultative purposes.Ìý