REGULATORY ANALYSIS

1.	Describe the classes of persons who will be affected by the proposed rule, including classes that will bear the costs of the proposed rule and classes that will benefit from the proposed rule.
There will be no impact to the Department or any class of persons where the rule reformats, clarifies and eliminates unnecessary or redundant language from the existing rule.  The change in length of prior authorization period from six months to up to 12 months for on-going care of chronically ill, technology dependent clients will be seamless to the client, will be a positive change for home health agency workload, and will allow more flexibility by the utilization review contractor for continued stay reviews. Clients will continue to have access to Administrative Law Judge appeals despite elimination of the reconsideration panel. The elimination of the reconsideration panel does not change the requirement for physician review of cases pursuant to the rule. The foster care plan requirement is unnecessary because these care plans do not alter the review decisions which are based upon medical criteria and the rule change will result in paperwork reduction. Increasing the timeframe for provider submission of discharge or revision information from one day to five working days will benefit providers and clients by allowing sufficient time to submit revision documentation and allow Private Duty Nursing services to continue without disruption, or clear the prior authorization from the Medicaid Managed Information System in order for other services to be implemented.
2.	To the extent practicable, describe the probable quantitative and qualitative impact of the proposed rule, economic or otherwise, upon affected classes of persons.
	Please see response to number 1.
3.	Discuss the probable costs to the Department and to any other agency of the implementation and enforcement of the proposed rule and any anticipated effect on state revenues.
There will be no cost to the Department or any other agency where the rule merely reformats, clarifies and eliminates unnecessary or redundant language from the existing rule.  There will be no cost to the Department or any other agency due to changes in the length of the prior authorization period from six months to 12 months for on-going care of chronically ill technology dependent clients. This extended prior authorization period is not available to first-time PDN clients and is limited based upon medical prognosis. Changing the prior authorization period does not change the ongoing need for physician prescription of care every 60 days. The client condition and Department expenditures remain the same over time for the clients who require care for a year or more despite the requirement for the home health agency to submit continuing stay information every six months.  The time frames for submission of discharge or prior authorization revisions by providers will not cost the Department and may benefit home health agencies by reducing denials for late submission of prior authorization paperwork. Elimination of the reconsideration panel may potentially save the Department by reducing the total cost of Private Duty Nursing utilization review in the next contract with Dual Diagnosis Management.   
4.	Compare the probable costs and benefits of the proposed rule to the probable costs and benefits of inaction.
Please see number 3 for probable costs.  The benefits of the proposed rule are to reduce unnecessary paperwork burdens for both home health agencies and the utilization review contractor while maintaining appropriate quality care for Private Duty Nursing clients at no additional cost to the Department.
5.	Determine whether there are less costly methods or less intrusive methods for achieving the purpose of the proposed rule.
None.
6.	Describe any alternative methods for achieving the purpose for the proposed rule that were seriously considered by the Department and the reasons why they were rejected in favor of the proposed rule.
None.