1030 Payments to nursing facilities; 1998-1999 proposed rates

Payments to Nursing Facilities; 1998-1999 Proposed Rates

[28 Pa.B. 2977]

   The purposes of this notice are to announce proposed changes in payment rates for nursing facilities beginning July 1, 1998, and to identify the methodology and justification for these proposed rates. Under 42 U.S.C.A. § 1902(a)(13)(A), as amended by section 4711 of the Balanced Budget Act of 1997, P. L. 105-33, § 4711, a State must use a public process when it proposes to make changes in payment rates or payment methodologies for nursing facility services under its approved Title XIX State Plan. The Department is not proposing to amend its State Plan or to change its regulations, 55 Pa. Code Chapter 1187, relating to the rate-setting methodology used to set nursing facility payment rates. Rather, the Department is proposing to make changes in its nursing facility payment rates because those rate changes are required by the rate-setting methodology contained in its approved State Plan and regulations.

Rates

   The proposed July 1, 1998 rates are available through the Bulletin Board System (BBS) at 1 [phone], at the local County Assistance Offices throughout the Commonwealth, or by contacting Connie Pretz in the Policy Section of the Bureau of Long Term Care Programs at [phone].

Methodology

   The methodology that the Department used to set the proposed rates is contained in 55 Pa. Code Chapter 1187, Subchapter G (relating to rate setting) and the Commonwealth's approved Title XIX State Plan.

Justification

   The justification for the proposed rates is that they were set under the rate-setting methodology required by the Commonwealth's approved State Plan and the current regulations.

   Nursing facility trade associations have expressed concern to the Department regarding the impact of the Minimum Data Set (MDS) 2.0, the Federally-approved instrument used to assess the physical, mental and psychosocial condition of nursing facility residents, on the case-mix indices (CMIs) used to establish the proposed rates. The Department is evaluating the actual impact of the MDS 2.0 on rates and will determine whether payment adjustments are necessary and appropriate to address any significant decreases in overall nursing facility payment rates resulting from a decline in CMIs.

   The estimated decrease in annual aggregate expenditures for Medical Assistance nursing facility services for FY 1998-1999 based on these proposed rates is $12.330 million ($5.712 million in State funds).

   Interested persons are invited to submit written comments about the proposed rates to the Department within 30 days of publication of this notice in the Pennsylvania Bulletin. Comments should be addressed to: Department of Public Welfare, Office of Medical Assistance Programs, Attention: Suzanne Love, Room 515 Health and Welfare Building, Harrisburg, PA 17120, [phone].

   Persons with a disability may use the AT&T Relay Services by calling [phone] (TDD Users) or [phone] (Voice Users). Persons who require another alternative should contact Thomas Vracarich in the Office of Legal Counsel at [phone].

FEATHER O. HOUSTOUN,   
Secretary

   Fiscal Note:  14-NOT-174. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 98-1030. Filed for public inspection June 26, 1998, 9:00 a.m.]