Pennsylvania Code
Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

• No statutes or acts will be found at this website.

The Pennsylvania Bulletin website includes the following: Rulemakings by State agencies; Proposed Rulemakings by State agencies; State agency notices; the Governor’s Proclamations and Executive Orders; Actions by the General Assembly; and Statewide and local court rules.

PA Bulletin, Doc. No. 01-959

NOTICES

DEPARTMENT OF
PUBLIC WELFARE

Additional Class of Disproportionate Share Payments to Hospitals

[31 Pa.B. 2851]

   The purpose of this notice is to announce the Department of Public Welfare's (Department) intent to establish an additional class of disproportionate share payments for hospitals that incur significant uncompensated care costs or that experience a high volume of inpatient cases, the cost of which exceeds twice the hospital's average cost per stay for all patients. This change will be effective June 30, 2001.

Hospital Uncompensated Care Payment

   The Department proposes to establish this additional class of payments to annually compensate facilities, which provide a disproportionate share of uncompensated care. A facility would qualify for this payment if the facility's total percentage of the following factors listed is above the median for all facilities.

   *  The facility's percentage of uncompensated care to net patient revenue as reported to the Pennsylvania Health Care Cost Containment Council (PHC4) over the 3 most recent fiscal year periods.

   *  The facility's percentage of SSI days to total inpatient days over the 3 most recent fiscal year periods.

   *  The facility's percentage of MA days to total inpatient days over the 3 most recent fiscal year periods.

   The Department will annually determine a payment percentage for each individual qualifying facility by comparing it to all qualifying facilities. The Department will annually publish a list of qualifying facilities in the Pennsylvania Bulletin by April 1 for the forthcoming fiscal year.

Hospital Extraordinary Expense Payment

   The Department also proposes to establish a class of disproportionate share payments to annually compensate facilities which incur extraordinary expenses in treating the uninsured on an inpatient basis. A facility may qualify for this payment if they do not qualify for a Hospital Uncompensated Care payment and the facility provided uncompensated care to a patient with extraordinary expenses in the most recent fiscal year for which data is available. Extraordinary expenses are those which exceed twice the hospital's average cost per stay for all patients.

   Payment to the facility shall equal the lesser of the cost of:

   *  The extraordinary expense claim; or

   *  The prorated amount of each facility's qualified extraordinary expense costs, as applied to the total funds available for these payments.

Fiscal Impact

   The Department intends to fund these additional payments from the Tobacco Settlement Fund. All Federal payment conditions are still applicable, namely, the Commonwealth may not exceed its aggregate annual disproportionate share allotment, and no hospital may receive disproportionate share payments in excess of its hospital-specific limit. Additionally, the total amount of funds received by a facility shall not exceed the uncompensated care amount reported to PHC4.

   Since the Tobacco Settlement legislation has not yet been enacted, the fiscal impact of the payments proposed under this notice cannot be determined at this time. The aggregate reimbursements for these additional classes of disproportionate share payments to hospitals will be dependent upon and limited to the amounts actually appropriated in the enacted legislation.

Contact Person

   A copy of this notice is available for review at local county assistance offices. Interested persons are invited to submit written comments to this notice within 30 days of this publication. These comments should be sent to the Department of Public Welfare, Office Of Medical Assistance Programs, Attention: Regulations Coordinator, Room 515 Health and Welfare Building, Harrisburg, PA 17105.

   Persons with a disability may use the AT&T Relay Service by calling (800) 654-5984 (TDD Users) or (800) 654-5988 (Voice Users). Persons who require an alternate format should contact Thomas Vracarich in the Office of Legal Counsel at (717) 783-2209.

FEATHER O. HOUSTOUN,   
Secretary

   Fiscal Note:  14-NOT-292. (1) General Fund (increases will be based on the passage of the Tobacco Settlement Act); (2) Implementing Year 2000-01 is Unknown; (3) 1st Succeeding Year 2001-02 is Unknown; 2nd Succeeding Year 2002-03 is Unknown; 3rd Succeeding Year 2003-04 is Unknown; 4th Succeeding Year 2004-05 is Unknown; 5th Succeeding Year 2005-06 is Unknown; (4) This is a new appropriation; therefore there is no program history. (7) new appropriation; (8) recommends adoption. Funds are contingent on the passage of appropriations from the Tobacco Settlement funds for this purpose.

[Pa.B. Doc. No. 01-959. Filed for public inspection June 1, 2001, 9:00 a.m.]


No part of the information on this site may be reproduced for profit or sold for profit.

This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.