12.1 (#5)           While it is understood that staff who work an excessive number of hours may not be providing their best service.  And we would all like to be able to pay staff a sufficient wage to allow them to support themselves and their families without working multiple jobs, the rates paid for these services do not necessarily support a “living wage.”  If staff are struggling they work additional hours (either for another provider or at the local WaWa) and that is not a discussion any employer can reasonably have! 

This particular requirement is specifically troublesome

• There is no way “other than self report” to obtain the information
• There is no clear consequence stated or implied – do you plan to have an MCO retract payment?  If so, for which individual and from which provider? 
• How would the MCO know that billing exceeded 750 (15 minute units) in any given week?   How would the provider know?

              Adding a requirement (which will also require monitoring by an entity with authority to do so) will not make a material difference for any provider inclined to skirt the edges of the rules, but will add an additional burden for all providers who make every attempt to comply. Adding a requirement (which will also require monitoring by an entity with authority to do so) will not make a material difference for any provider inclined to skirt the edges of the rules, but will add an additional burden for all providers who make every attempt to comply.  How will you know, and how will you monitor, and what are the consequences for non-compliance?