Additional Class of Disproportionate Share Payments to Qualifying Teaching Hospitals [44 Pa.B. 2588]
[Saturday, April 26, 2014]The Department of Public Welfare (Department) is announcing its intent to change its qualifying criteria and payment methodology for disproportionate share hospital (DSH) payments to qualifying teaching hospitals that provide psychiatric services to Medical Assistance (MA) beneficiaries. The Department intends for this funding to be used to help offset medical education costs of psychiatrists which are incurred by hospitals providing psychiatric care to MA beneficiaries and the uninsured. In addition, the Department is announcing its intent to allocate funding for these DSH payments for Fiscal Year (FY) 2013-2014.
The Department intends to modify the current qualifying criteria for DSH payments to qualifying acute care general hospitals. The Department proposes to consider any psychiatric unit of a general acute care hospital enrolled in Pennsylvania (PA) MA Program with PA MA psychiatric medical education costs that exceed $40,000, according to the FY 2010-2011 MA Cost Report, eligible for this additional class of DSH payments if it meets one of the following criteria:
1. The hospital provides at least 40,000 psychiatric days of service to PA MA beneficiaries as reported on the 2010-2011 MA Cost Report.
2. The hospital's percentage of PA MA fee-for-service (FFS) inpatient psychiatric days to total PA MA FFS inpatient days exceeds 25% as reported on the FY 2010-2011 MA Cost Report.
The Department also intends to modify the payment methodology for these DSH payments. Specifically, the Department proposes to distribute 2/3 of the amount appropriated for these payments equally to teaching hospitals qualifying under previously listed criteria 1. The Department intends to distribute 1/3 of the amount appropriated for these payments equally to teaching hospitals qualifying under previously listed criteria 2. Hospitals that qualify under both criteria will be eligible only for payment under criteria 1.
The Department will allocate funding for these DSH payments at the same level as allocated for FY 2012-2013.
Payment limitations will still be applicable, including those limitations prohibiting the Commonwealth from exceeding its aggregate annual DSH allotment and prohibiting a hospital from receiving DSH payments in excess of its hospital-specific limit.
Fiscal Impact
The FY 2013-2014 impact, as a result of the funding allocation for these payments is $0.500 million ($0.231 million in State general funds and $0.269 million in Federal funds upon approval by the Centers for Medicare and Medicaid Services).
Public Comment
Interested persons are invited to submit written comments regarding this notice to the Department of Public Welfare, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. The Department will consider all comments received within 30 days of this notice.
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).
BEVERLY D. MACKERETH,
SecretaryFiscal Note: 14-NOT-861. (1) General Fund; (2) Implementing Year 2013-14 is $231,000; (3) 1st Succeeding Year 2014-15 is $0; 2nd Succeeding Year 2015-16 is $0; 3rd Succeeding Year 2016-17 is $0; 4th Succeeding Year 2017-18 is $0; 5th Succeeding Year 2018-19 is $0; (4) 2012-13 Program—$268,112; 2011-12 Program—$325,685; 2010-11 Program—$243,809; (7) MA—Inpatient; (8) recommends adoption. Funds have been included in the budget to cover this increase.
[Pa.B. Doc. No. 14-895. Filed for public inspection April 25, 2014, 9:00 a.m.]
