Rate Setting

The Rate Setting Unit is responsible for determining adequate methods of reimbursement for departmental services provided by designated agencies. The goal is to develop rates for services that will be cost effective and affordable as well as meeting the service delivery system's needs. To achieve this goal Rate Setting staff work with Department program staff to develop and implement financial policies and procedures with regard to rate methodologies to be used to reimburse services. A partial list of other functions Rate Setting performs is:

• Participation in policy development
• Prepare reports for legislature
• Analyze the impact of proposed price changes on providers, state budget, and Medicaid program
• Assists in standardizing rates for similar services
• Recommends new methods of reimbursement
• Works as a resource for other agencies establishing new rates for services
• Responsible for responding to inquiries from providers, agencies and legislatures on pricing of medical services provided by the Department to members of the Medicaid program

Service Areas of Responsibilty