Medicaid Rates: Understanding the 70% Accountability Requirement and PDPM Phase-In

This in-depth session is designed for finance, reimbursement, and administrative professionals working in skilled nursing and post-acute care. Participants will gain a comprehensive understanding of how Pennsylvania’s Medicaid Fee-for-Service (FFS) rates are calculated, both quarterly and annually, and how these rates are impacted by the MA-11 cost report. The webinar will provide detailed walkthroughs of rate-setting methodologies, including sample calculations.

Special focus will be given to the 70% Accountability Requirement, which now applies to full-year cost reports beginning on or after January 1, 2023. We’ll explain how this accountability threshold is calculated, how penalties are applied when not met, and what providers can do to prepare.

With the transition from RUGs to PDPM underway, participants will also examine how this change affects rate calculations during the phase-in period, with practical examples and strategic considerations.

This session offers valuable insights for financial managers, CPAs, administrators, and reimbursement specialists who need to understand how Medicaid payment policy directly affects their facility’s revenue and compliance.

This program has been submitted but not yet approved for Continuing Education for 1.0 total participation hours by NAB/NCERS.

Financial Professionals: This program qualifies for Continuing Education 1.2 total clocked hours from the CPA (State Board of Accountancy). LeadingAge PA is registered with the Pennsylvania State Board of Accountancy, Program Sponsor #PX000987L. 

To receive continuing education credit for LeadingAge PA-sponsored webinars, attendees must register under their name, participate through the link supplied after registering and complete the evaluation after the webinar.