DEPARTMENTAL GRANT APPEALS BOARD
Department of Health and Human Services
SUBJECT: Pennsylvania Department of Public Welfare
Docket No. 87-204
Decision No. 965
DATE: July 11, 1988
DECISION
The Pennsylvania Department of Public Welfare (State) appealed a
decision
by the Health Care Financing Administration (Agency)
disallowing $1,250,136
in federal financial participation (FFP) claimed
by the State for Medicaid
administrative expenditures for the period
April 1, 1986 through March 31,
1987. The disallowance was later
reduced to $1,071,006 by the
Agency. The State agreed that the items of
costs disallowed here are
the same in substance as the costs discussed
in Pennsylvania Dept. of Public
Welfare, DGAB No. 832 (1987).
That decision involved the difference between the State's claims for
costs
at the 75% rate available for operation of a Medicaid Management
Information
System (MMIS) and the 50% rate available generally for
administrative
costs. Specifically, the dispute there involved whether
the costs of
two divisions of the Bureau of Provider Relations and
certain postage costs
were reimbursable as operational costs of an MMIS
at the 75% rate or as
Medicaid administrative costs at the 50% rate.
In Pennsylvania, the State conceded the disallowance for 14
job
classifications charged to MMIS. In addition, the parties agreed
to
pursue certain issues on remand. As for the remaining issues, the
Board
sustained the disallowance of the following:
o The costs of developing and maintaining provider
handbooks and of
writing assistance bulletins (the
Division of Provider Education).
o The costs of responding to provider questions regarding
billing
problems and processing exceptions to the
deadline for submitting
invoices (the Division of
Provider Inquiry).
o All postage costs -- except for reconciliation tapes,
which the
Board determined to be allowable.
The State admitted that this case involved the same legal and
factual
issues which were before the Board in Decision No. 832, and the
State
agreed to the issuance of a summary decision on the basis of
that
decision. Moreover, the parties agreed that the amount at issue
here is
attributable to only those cost items for which the 75% rate
is
unavailable in accordance with the earlier Pennsylvania decision.
Therefore, we sustain the disallowance of $1,071,006, based on
DGAB
Decision No. 832 (which we incorporate by reference here).
_________________________ Judith
A.
Ballard
_________________________ Norval D.
(John)
Settle
_________________________ Cecilia
Sparks
Ford Presiding Board Member