Establishment of an Additional Class of Disproportionate Share Payments [41 Pa.B. 1714]
[Saturday, March 26, 2011]The Department of Public Welfare (Department) is providing final notice of the establishment of an additional class of disproportionate share hospital (DSH) payments to certain qualifying hospitals that the Department determines provide a high volume of services to Medical Assistance (MA) eligible and low-income populations. The Department intends for these payments to promote the hospitals' continued participation in the MA Program.
The Department will consider a hospital eligible for this additional class of DSH payments if the hospital is an acute care hospital that meets all of the criteria listed as follows.
a) The hospital is located in a county that exceeds the 96th percentile of the unduplicated number of persons eligible for MA, by county (January 2010 MA undup-licated eligibility report).
b) The hospital provides more than 58,000 patient days of service as reported on its 2007-2008 State Fiscal Year (FY) MA cost report (MA-336).
c) The hospital's ratio of Pennsylvania MA days to total hospital days is more than 20% as reported on its 2007-2008 State FY MA cost report (MA-336).
d) The hospital's FY 2008 Uncompensated Care percentage of Net Patient Revenue is greater than 2.4%, as reported in the Health Care Cost Containment Council's Fiscal Year 2008 Financial Analysis, Volume One, General Acute Care Hospitals.
e) The hospital's FY 2008 operating margin is less than -3.4%, as reported in the Health Care Cost Containment Council's Fiscal Year 2008 Financial Analysis, Volume One, General Acute Care Hospitals.
Payments are divided proportionately between qualifying hospitals based on the percentage of each qualifying hospital's MA inpatient days to total MA inpatient days of all qualifying facilities. In making these payments, the Department ensures that no acute care hospital will receive any DSH payment that is in excess of its hospital-specific limit and the Commonwealth will not exceed its aggregate annual DSH allotment. Any funds available due to the application of the hospital-specific DSH upper payment limit will be redistributed to other hospitals qualifying under this class of disproportionate share payments on a proportionate basis.
The Department published notice of its intent to establish an additional class of DSH payments to certain qualifying hospitals that provide a high volume of services to MA eligible and low-income populations at 40 Pa.B. 3619 (June 26, 2010). The Department received no public comments during the 30-day comment period, and will implement the changes described in its notice of intent.
Fiscal Impact
The FY 2009-2010 fiscal impact as a result of this additional class of DSH payments is $1.882 million ($0.851 million in State General Funds).
GARY D. ALEXANDER,
Acting SecretaryFiscal Note: 14-NOT-664. (1) General Fund; (2) Implementing Year 2009-10 is $851,000; (3) 1st Succeeding Year 2010-11 is $851,000; 2nd Succeeding Year 2011-12 is $851,000; 3rd Succeeding Year 2012-13 is $851,000; 4th Succeeding Year 2013-14 is $851,000; 5th Succeeding Year 2014-15 is $851,000; (4) 2009-10 Program—$373,515,000; 2008-09 Program—$426,822,000; 2007-08 Program—$468,589,000; (7) MA—Inpatient; (8) recommends adoption. Funds have been included in the budget to cover this increase.
[Pa.B. Doc. No. 11-528. Filed for public inspection March 25, 2011, 9:00 a.m.]
