Section 759.14 - Payment

759.14  Payment

(a) Payments to adult day health care programs by State government agencies. A program may only bill for one visit per registrant per day.  

(b) Payments to adult day health care programs by managed care organizations or care coordination models:

(1) Payments shall be made in accordance with the negotiated agreement between the adult day health care program and the managed care organization or care coordination model.

(2) The full range of adult day health care services shall be available to registrants with a documented need for such services. Based on a registrant’s individual needs, as determined in the comprehensive assessment, the managed care organization or care coordination model may order less than the full range of adult day health care services. Nothing shall prohibit adult day health care programs and managed care organizations or care coordination models from agreeing to reimbursement terms that reflect a registrant’s receipt of less than the full range of adult day health care services.

Effective Date: 
Wednesday, June 14, 2017