385 Disproportionate share hospital payments for access to care

DEPARTMENT OF
HUMAN SERVICES

Disproportionate Share Hospital Payments for Access to Care

[46 Pa.B. 1290]
[Saturday, March 5, 2016]

 The Department of Human Services (Department) is announcing its intended funding allocations for two classes of disproportionate share hospital (DSH) payments made to qualifying Medical Assistance (MA) enrolled acute care general hospitals. The Department does not intend to otherwise change its approved State Plan provisions addressing the qualifying criteria or payment methodology for these payments.

 All payment limitations are applicable, including those limitations that the Commonwealth may not exceed its aggregate annual DSH allotment, and that no hospital may receive DSH payments in excess of its hospital-specific limit.

Background

 The Department intends to allocate funding for two classes of DSH payments to qualifying acute care general hospitals for Fiscal Year (FY) 2015-2016. Specifically, these classes of payments include DSH payments to hospitals providing enhanced access to multiple types of medical care in economically distressed areas and DSH payments to hospitals providing a high volume of services to MA and low-income populations.

DSH Payments to Hospitals Providing Enhanced Access to Multiple Types of Medical Care in Economically Distressed Areas

 For FY 2015-2016, the Department intends to allocate $15.237 million ($7.312 million in State general funds and $7.925 million in Federal funds) upon approval by Centers for Medicare and Medicaid Services (CMS) for DSH payments to qualified hospitals providing enhanced access to multiple types of medical care in economically distressed areas.

DSH Payments to Hospitals Providing a High Volume of Services to MA and Low-Income Populations

 For FY 2015-2016, the Department intends to allocate $1.651 million ($0.792 million in State general funds and $0.859 million in Federal funds) upon approval by CMS for DSH payments to qualified hospitals providing a high volume of services to MA and low-income populations.

Fiscal Impact

 The FY 2015-2016 fiscal impact, as a result of these payments, is $16.888 million ($8.104 million in State general funds and $8.784 million in Federal funds) upon approval by CMS.

 

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. The Department will review and consider comments received within 30 days in determining the final payment methodology for these payments.

 Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at [phone] (TDD users) or [phone] (voice users).

THEODORE DALLAS, 
Secretary

 Fiscal Note: 14-NOT-997. (1) General Fund; (2) Implementing Year 2015-16 is $8,104,000; (3) 1st Succeeding Year 2016-17 through 5th Succeeding Year 2020-21 are $0; (4) 2014-15 Program—$564,772,000; 2013-14 Program—$428,041,000; 2012-13 Program—$718,947,000; (7) MA—Fee-for-Service; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 16-385. Filed for public inspection March 4, 2016, 9:00 a.m.]