441—153.56 (331) Program administration.
	 153.56(1) CPC responsibilities.
	  a.   	 Financial participation on the part of the member shall be governed by the financial participation provisions of the approved county management plan of the member’s county of residence.
	  b.   	 The CPC or the CPC’s designee shall submit to the division’s state payment program manager by the fifth business day of each month a report on the eligible services paid for during the previous month. The report shall be submitted electronically and shall include the following data in each record:
	 (1) 	 The calendar month and year in which the county made the payment.
	 (2) 	 The name of the county submitting the information.
	 (3) 	 The member’s name.
	 (4) 	 The member’s state identification number.
	 (5) 	 The member’s identification number as assigned under subparagraph 153.56(2)“a”(2).
	 (6) 	 The member’s diagnostic group code.
	 (7) 	 The provider’s name.
	 (8) 	 The chart of accounts code for each service paid.
	 (9) 	 The number of units paid (if applicable).
	 (10) 	 The beginning date of each service for which the county paid.
	 (11) 	 The ending date of each service for which the county paid.
	 (12) 	 The dollar amount paid.
	  c.   	 The CPC or the CPC’s designee shall include payments made on behalf of members in the data warehouse annual reports required by 441—Chapter 25, Division IV.
	 153.56(2) Department responsibilities. As the sponsoring agency, the department shall be responsible for:
	  a.   	 Enrolling members as necessary to produce payment to the counties, including:
	 (1) 	 Maintaining member information in the data system for payment;
	 (2) 	 Notifying counties of the member identification number required for billing; and
	 (3) 	 Closing data system files on members as directed by the counties, or when the member has not had any payments processed for a 12-month period.
	  b.   	 Verifying receipt of monthly payment report files. Within 15 business days of receipt of each county’s monthly payment report file, the department shall:
	 (1) 	 Identify the county’s payment amount for that month and the number of clients included in the payment; and
	 (2) 	 Notify the county of any clients whose costs were denied and the reason for the denial.
	  c.   	 Generating and reconciling payments to the counties.
	  d.   	 Receiving and auditing reports of member activity and expenditures from the counties.
	 153.56(3) Payment to counties. The following policies shall govern payment to counties for services furnished to members:
	  a.   	 Monthly payment. Beginning in May 2007, the department shall make a monthly payment to each county based on the expense report for the previous month that was submitted by the county pursuant to paragraph 153.56(1)“b.” The department shall process monthly payments by the twentieth day of each month.
	  b.   	 Prospective payment. The department may make a prospective payment to the county for cash flow purposes by July 10 of each year.
	 (1) 	 The prospective payment shall be based on the sum of the expense reports that the department received from the county in April, May, and June of that year.
	 (2) 	 For the state fiscal year ending June 30, 2007, the payments made to the county on or before April 1, 2007, shall be considered the prospective payment.
	  c.   	 Payment reconciliation. The department and counties shall reconcile the total of the prospective payment and monthly payments made to a county with the total actual expenses paid by the county for that same period.
	  d.   	 Payment adjustment. Beginning in April of each year, the department may adjust the monthly payment to the county to:
	 (1) 	 Spend down the balance of the prospective payments previously made; or
	 (2) 	 Make additional payment to ensure that the county has sufficient moneys for cash flow purposes.
	  e.   	 Deductions. For the state fiscal year ending June 30, 2007, moneys that the county received but did not expend, according to the report required by paragraph 153.56(1)“b,” shall be deducted from the county’s subsequent payment.