TITLE 405 OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES
Economic Impact Statement
LSA Document #18-251
IC 4-22-2.1-5 Statement Concerning Rules Affecting Small Businesses
The Indiana Family and Social Services Administration (FSSA) Office of Medicaid Policy and Planning (OMPP) proposes to:
(8) Add
405 IAC 1-1.4 to update and streamline the program integrity rules.
(10) Repeal
405 IAC 1-5 to align with the new updated rules.
(13) Repeal
405 IAC 5-4 to align with the new updated rules.
The following section provides responses to the following questions outlined in
IC 4-22-2.1-5:
1. An estimate of the number of small businesses, classified by industry sector, that will be subject to the proposed rule.
IC 5-28-2-6 defines a small business as a business entity that satisfies the following requirements:
(1) On at least fifty percent (50%) of the working days of the business entity occurring during the preceding calendar year, the business entity employed not more than one hundred fifty (150) employees.
(2) The majority of the employees of the business entity work in Indiana.
The OMPP estimates that out of a total of 26,146 Medicaid-enrolled providers in Indiana, there are 21,254 providers that may meet the criteria of a small business.
2. An estimate of the average annual reporting, record keeping, and other administrative costs that small businesses will incur to comply with the proposed rule.
The proposed rule amendment will not impose any additional annual reporting, record keeping, or other administrative costs on small businesses in order to comply with the proposed rule. The proposed rule will shorten some timelines but the reporting is the same. Currently, 95% of all claims are submitted in the first 90 days after service and approximately 99% are submitted within the proposed 180 days. Additionally, there are always exceptions to the timely filing limit that all providers should be aware of such as retroactive eligibility, level of care requirements, third party liability, and several other exceptions. OMPP expects all providers to comply with this change without any increase in costs to providers or small businesses.
3. An estimate of the total annual economic impact that compliance will have on small businesses subject to the rule.
Since no small businesses will incur any additional cost to comply with this rule, there is no economic impact that compliance will have on a small business subject to this rule.
4. A statement justifying any requirement or cost that is imposed by the rule and not expressly required by law. The statement must reference any data, studies, or analyses relied upon by the agency in determining imposition of the requirement or cost is necessary.
The proposed rule amendment will not impose any requirement or cost on small businesses in order to comply with the proposed rule.
5. Any regulatory flexibility analysis that considers any less intrusive or less costly alternative methods of achieving the same purpose.
Other factors considered:
A. Establishment of less stringent compliance or reporting requirements for small businesses.
The rule has no impact on reporting requirements for small businesses. The changes to the rule affect timelines for reimbursement and claim filing and alternatives for small businesses would not achieve the goals of the rule.
B. Establishment of less stringent schedules or deadlines for compliance or reporting requirements for small businesses.
The rule has no impact on schedules or deadlines for compliance or reporting requirements for small businesses. The changes to the rule affect timelines for reimbursement and claim filing and alternatives for small businesses would not achieve the goals of the rule.
C. Consolidation or simplification of compliance or reporting requirements for small businesses.
The rule has no impact on compliance or reporting requirements for small businesses. The changes to the rule affect timelines for reimbursement and claim filing and alternatives for small businesses would not achieve the goals of the rule.
D. Establishment of performance standards for small businesses instead of design or operational standards imposed on other regulated entities by the rule.
The rule has no impact on performance or operational standards for small businesses.
E. Exemption of small businesses from part or all of the requirements or costs imposed by the rule.
The rule imposes no additional requirements or cost on small businesses. The changes to the rule affect timelines for reimbursement and claim filing and alternatives for small businesses would not achieve the goals of the rule.
If there are any programmatic or fiscal questions, please contact James Waddick at (317) 234-7484 or at james.waddick@fssa.in.gov. Questions regarding any other aspect of the proposed changes should also be addressed to Jeremy Hoffman at (317) 234-6579 or at jeremy.hoffman@fssa.in.gov.
Posted: 10/03/2018 by Legislative Services Agency
DIN: 20181003-IR-405180251EIA
Composed: Apr 19,2024 9:52:25PM EDT
A
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