1525 Medical Assistance Program fee increases for private duty/shift nursing services to MA beneficiaries under 21 years of age

DEPARTMENT OF HUMAN SERVICES

Medical Assistance Program Fee Increases for Private Duty/Shift Nursing Services to MA Beneficiaries Under 21 Years of Age

[46 Pa.B. 5781]
[Saturday, September 3, 2016]

 The Department of Human Services (Department) is announcing that it increased the Medical Assistance (MA) Program fees for the following private duty/shift nursing services provided to MA beneficiaries under 21 years of age effective July 1, 2016.

Fee Update

 As required by section 1729-B of the act of July 13, 2016 (P.L. 664, No. 85), the Department increased the MA Program fees for select private duty/shift nursing services as follows:

Procedure Code	Description	Current MA Fee	MA Fee Effective July 1, 2016
S9123	Nursing care, in the home; by Registered Nurse, per hour	$40.00	$45.00
S9124	Nursing care, in the home; by Licensed Practical Nurse, per hour	$40.00	$45.00

 The Department has updated the MA Program's Fee Schedule to reflect the increase in payment for identified nursing services. An MA Bulletin will be issued to providers with instructions for billing.

Fiscal Impact

 This change will result in an estimated annual payment of $10.856 million in total funds ($3.882 million in State funds) in Fiscal Year 2016-2017.

Public Comment

 Interested persons are invited to submit written comments regarding the revised payment rate 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 by the Department.

 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-1054. (1) General Fund;

 (7) MA—Capitation; (2) Implementing Year 2016-17 is $3,221,000; (3) 1st Succeeding Year 2017-18 through 5th Succeeding Year 2021-22 are $14,059,000; (4) 2015-16 Program—$3,828,000,000; 2014-15 Program—$3,823,000,000; 2013-14 Program—$3,995,000,000;

 (7) MA—Fee-for-Service; (2) Implementing Year 2016-17 is $661,000; (3) 1st Succeeding Year 2017-18 through 5th Succeeding Year 2021-22 are $700,000; (4) 2015-16 Program—$392,918,000; 2014-15 Program—$564,772,000; 2013-14 Program—$428,041,000;

 (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 16-1525. Filed for public inspection September 2, 2016, 9:00 a.m.]