1695 Medical Assistance reliant hospital supplemental payment

DEPARTMENT OF
PUBLIC WELFARE

Medical Assistance Reliant Hospital Supplemental Payment

[43 Pa.B. 5538]
[Saturday, September 14, 2013]

 The purpose of this notice is to announce that the Department of Public Welfare (Department) intends to amend the Commonwealth's Title XIX State Plan to authorize supplemental payments to certain acute care general hospitals that provide a large portion of their services to Pennsylvania (PA) Medical Assistance (MA) consumers. These hospitals provide critical services to the MA population as well as to uninsured individuals, and they rely almost entirely on MA revenue for their ongoing operations.

Background

 Hospitals with a patient population consisting mainly of MA consumers provide access to hospital services that otherwise may not be available to these individuals. To assure that these hospitals can continue their participation in the MA Program and provide needed services to the MA population, the Department intends to make supplemental payments to these facilities.

 To qualify for the supplemental payments, a hospital enrolled in the PA MA Program as an acute care general hospital must provide at least 80% of its inpatient days of care to PA MA (managed care and fee for service) consumers as evidenced by the hospitals' Fiscal Year (FY) 2009-2010 MA cost report (MA 336).

 Payments will be divided proportionately among qualifying hospitals based on the percentage of each qualifying hospital's PA MA inpatient days to the total PA MA inpatient days for all qualifying hospitals. All payment limitations are still applicable, including that payments to a qualifying hospital may not exceed its hospital specific limit as defined by section 1923 of the Social Security Act (42 U.S.C.A. § 1396r-4).

Fiscal Impact

 The FY 2013-2014 impact, as a result of the funding allocation for this payment is $0.300 million ($0.139 million in State general funds and $0.161 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. Comments received within 30 days will be reviewed and considered by the Department.

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

BEVERLY D. MACKERETH, 
Secretary

 Fiscal Note: 14-NOT-842. (1) General Fund; (2) Implementing Year 2013-14 is $139,000; (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—$268,112,000; 2011-12 Program—$325,685,000; 2010-11 Program—$243,809,000; (7) MA—Inpatient; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 13-1695. Filed for public inspection September 13, 2013, 9:00 a.m.]