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DHS tells committee it will finish PRTF Medicaid rate reviews by December
Summary
DHS officials said stakeholder work on psychiatric residential treatment facility (PRTF) rates began June 29, with draft comparison rates expected in September and a final report aimed for December; DHS said retroactive payments could be considered if actuarially justified and CMS allows.
Department of Human Services officials told the Senate Public Health, Welfare and Labor Committee they are concluding a multi‑year review of Medicaid provider rates that includes psychiatric residential treatment facilities (PRTFs). Mark White said the governor directed statewide Medicaid rate reviews in 2019; Elizabeth Pittman described a stakeholder process with an actuarial vendor (Milliman) and behavioral‑health experts.
Pittman said DHS held a kickoff work group on June 29 and will conduct stakeholder webinars through July, develop comparison‑rate assumptions and draft rates by September, and work with stakeholders in October and November to finalize recommendations. She said all 13 PRTF providers will be included in the review and that DHS aims for a final report by December and will meet as often as needed to meet that timeline.
On retroactivity, Pittman said DHS will consider retroactive rate adjustments if actuaries support that approach and if CMS allows, noting pandemic‑era flexibilities that previously enabled retroactivity may be narrowing. Committee members asked whether DHS could finalize the work by the December meeting; Pittman said that is the plan and DHS will pursue retroactivity only where appropriate and permissible.
The presentation included process details (cost surveys, comparison rate assumptions, and further stakeholder engagement) and did not include a specific per‑diem increase; Pittman said DHS will consider multiple options and rely on actuarial studies to justify any retroactive payments.
Next steps: DHS will proceed through the stakeholder schedule, produce draft rates in September and report final recommendations before the committee’s December meeting.
