Autism Benefit Payments Sample Clauses

Autism Benefit Payments. Payments to the PIHPs under this benefit will occur in two ways and include administrative costs for training and the provision of monthly interim payments. The administrative costs for training will be paid to each of the PIHPs prospectively in the form of a gross adjustment. There will be no cost settlement on the administrative costs for training. For the Applied Behavior Analysis (ABA) services, monthly interim payments will be paid retrospectively. Each interim payment will be issued at one of two levels, Early Intensive Behavioral Intervention (EIBI) or Applied Behavioral Intervention (ABI), and will be triggered by the combination of meeting the criteria for this benefit at a particular level, as laid out in the MSA Bulletin Number: MSA 13-09 and the 1915 (i) SPA, and having at least one encounter submitted by the end of the fourth month after a particular service month for that month. A cost settlement process will cover the actual costs associated with ABA services, as well as assessments related to potential eligibility for these services, submitted for a particular fiscal year. This process could result in additional payment to or recoupment from each PIHP. That cost settlement process will take place no earlier than the March after the fiscal year being settled. The rates for the monthly interim payments for the period January 1, 2014 through September 30, 2014 are: Applied Behavioral Analysis (ABI): $1,925 Early Intensive Behavioral Intervention (EIBI): $2,673 Monthly Interim Payments for MIChild will be paid in the same manner and at the same rate as the Medicaid interim payment and will be cost settled. There will be no administrative training costs paid for the MIChild benefit. The cost settlement process will separately settle the Medicaid interim payments and MI Child interim payments against the actual service costs for each category.
Sample 1
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Related to Autism Benefit Payments

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