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PA Bulletin, Doc. No. 97-607

NOTICES

INDEPENDENT REGULATORY REVIEW COMMISSION

Actions Taken by the Commission

[27 Pa.B. 1987]

   The Independent Regulatory Review Commission met publicly at 11 a.m., Thursday, April 3, 1997, and took the following actions:

Regulations Approved:

   Department of Public Welfare #14-437:  Nursing Facility Intergovernmental Transfer (amends 55 Pa. Code Chapter 1187)

Commissioners Present:  John R. McGinley, Jr., Chairperson; Robert J. Harbison, III, Vice-Chairperson; Alvin C. Bush; Arthur Coccodrilli; John F. Mizner

Department of Public Welfare--Nursing Facility Intergovernmental Transfer; Doc. No. 14-437

Order

   On March 13, 1997, the Independent Regulatory Review Commission (Commission) received this regulation from the Department of Public Welfare (DPW). This rulemaking would amend 55 Pa. Code Chapter 1187. The authority for this regulation is contained in section 443.1 of the Public Welfare Code (62 P. S. § 443.1). Notice of proposed rulemaking was omitted for this regulation, it will become effective upon publication in the Pennsylvania Bulletin.

   Federal law allows states to use funds transferred from public entities, such as county governments, to quality as part of the State's share of funding for Medicaid services. This money is matched by the Federal government. Over the past several years, the DPW has taken advantage of this provision by entering into an intergovernmental agreement with several county governments.

   Most recently, the DPW has entered into an intergovernmental agreement with a group of county governments for fiscal year 1995-96. As a result of this agreement, the DPW has obtained additional Federal funds for nursing home services. Through discussions with the county nursing homes, an agreement was made as to how these additional funds should be distributed.

   In August of last year, we approved Regulation Number 14-435 that implemented the 1995-96 agreement for the first half of the 1995-96 fiscal year. This regulation provides for how the funds for the remaining portion of the agreement will be used. Specifically, the regulation provides for a transition rate (that is, the higher of their case-mix rate or an ''adjusted'' previous rate) for county nursing homes for the last half of fiscal year 1995-96, as well as for fiscal years 1996-97, 1997-98 and the first half of fiscal year 1998-99. The purpose of the transition rate is to help county nursing homes adjust to the new prospective reimbursement system, commonly referred to as case-mix, which began on January 1, 1996.

   The regulation also provides for payment of a retroactive transition rate for nursing homes, other than county, hospital based or special rehabilitation homes, for the period of January 1, 1996 through June 30, 1996. As with the county transition rate, the purpose of this payment is to help these homes adjust to the new reimbursement system. The funds for this transition rate also come from the intergovernmental transfer agreement.

   The regulation will result in an additional $21.5 million being expended on nursing home services from January 1996 through December 1998. Of this $21.5 million, $13 million will be reimbursed to county nursing homes and the remainder to private and non-profit nursing homes.

   We have reviewed this regulation and find it to be in the public interest. The regulation is necessary to detail how funds from the intergovernmental transfer agreement will be expended. The additional funds from the agreement will allow nursing homes participating in the Medicaid program to better serve those in need of nursing home services.

Therefore, It Is Ordered That:

   1.  Regulation No. 14-437, from the Department of Public Welfare, as submitted to the Commission on March 13, 1997, is approved; and

   2.  The Commission will transmit a copy of this Order to the Legislative Reference Bureau.

JOHN R. MCGINLEY, Jr.,   
Chairperson

[Pa.B. Doc. No. 97-607. Filed for public inspection April 18, 1997, 9:00 a.m.]


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