DEPARTMENT OF
HUMAN SERVICESHospice Services Room and Board Payment Rates [45 Pa.B. 1576]
[Saturday, March 28, 2015]The Department of Human Services (Department) is clarifying the payment methodology for hospice providers that render hospice services to Medical Assistance (MA) beneficiaries who reside in a nonpublic nursing facility, a county nursing facility, a State-operated nursing facility including a State veterans' home, or an intermediate care facility for individuals with intellectual disabilities or other related conditions.
Discussion
Section 1905(o) of the Social Security Act (42 U.S.C.A. § 1396d(o)) provides for an additional payment for hospice care that is furnished to an individual who is a resident of a nursing facility or intermediate care facility for the intellectually disabled (ICF/ID) and eligible for nursing facility services or services in an ICF/ID. See also 55 Pa. Code § 1130.73 (relating to additional payment for nursing facility residents). The additional payment is to take into account the room and board furnished by the facility and must equal at least 95% of the rate that is paid by the state under the plan for facility services in that facility for that individual. See section 1902(a)(13)(B) of the Social Security Act (42 U.S.C.A. § 1396a(a)(13)(B)). In response to an inquiry from the Centers for Medicare and Medicaid Services, the Department is clarifying that the additional room and board payment made to the hospice provider is at least 95% of the nursing facility or ICF/ID per diem amount.
Fiscal Impact
The Department anticipates there will be no increase in costs to the MA Program as a result of this clarification.
Public Comment
Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments received within 30 days will be reviewed and considered.
Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
THEODORE DALLAS,
Acting SecretaryFiscal Note: 14-NOT-943. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 15-566. Filed for public inspection March 27, 2015, 9:00 a.m.]
