NOTICES
Intention to Establish an Additional Class of Disproportionate Share Payments
[34 Pa.B. 5316] The purpose of this notice is to provide prior public notice of the Department of Public Welfare's (Department) intent to establish an additional class of disproportionate share payments for certain qualifying hospitals.
The Department intends to make this payment, in addition to the classes of disproportionate share payments already made under the Medical Assistance (MA) Program, to certain hospitals, which the Department has determined provide a high volume of services to MA eligible and low income populations in medically underserved areas. This payment is intended to assure the hospitals' continued participation in the MA Program. For a hospital to qualify for payments, the hospital must be an acute care hospital that met all of the following criteria in State Fiscal Year 1999-2000:
a) The ratio of MA days to total hospital patient days exceeds 35%.
b) The hospital provides in excess of 50,000 patient days of service.
c) The hospital has an occupancy ratio (total patient days used divided by total bed days available) of at least 70%.
d) The hospital has a Low-Income Utilization Rate of at least 40%.
e) The hospital is located in a census tract (United States Census 2000) designated by the Bureau of Primary Health Care of the Health Resources and Services Administration as a Medically Underserved Area and serves a market area that is at least 95% minority based.
f) The hospital has a government dependency ratio, comprised of MA Percentage of Net Patient Revenue plus Medicare Percentage of Net Patient Revenue, in excess of the 95th percentile for all Commonwealth acute care hospitals.
The Department intends to allocate $1.5 million in State Fiscal Year 2004-2005 from the State General Fund for this additional class of payments. Payments will be divided proportionately between qualifying hospitals based on the percentage of each qualifying hospital's MA inpatient days to total MA inpatient days of all qualifying facilities. Payment limitations are still applicable, including those limitations that the Commonwealth may not exceed its aggregate annual disproportionate share allotment and that no hospital may receive disproportionate share payments in excess of its hospital-specific limit.
Fiscal Impact
For Fiscal Year 2004-2005, the fiscal impact as a result of this additional class of disproportionate share payments will be $3.316 million in total funds ($1.5 million in State General funds and $1.816 million in Federal funds).
Public Comment
Interested persons are invited to submit written comments to this notice within 30 days of publication to the Department of Public Welfare, Office of Medical Assistance Programs c/o Deputy's Secretary Office, Attn: Regulations Coordinator, Room 515 Health and Welfare Building, Harrisburg, PA 17120. Persons with a disability may use the AT&T Relay Service, (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
ESTELLE B. RICHMAN,
SecretaryFiscal Note: 14-NOT-399. (1) General Fund; (2) Implementing Year 2004-05 is $1,500,000; (3) 1st Succeeding Year 2005-06 is $0; 2nd Succeeding Year 2006-07 is $0; 3rd Succeeding Year 2007-08 is $0; 4th Succeeding Year 2008-09 is $0; 5th Succeeding Year 2009-10 is $0; (4) 2003-04 Program--$429,061,000; 2002-03 Program--$372,670,000; 2001-02 Program--$407,104,000; (7) Medical Assistance--Inpatient; (8) recommends adoption. The costs outlined have been included in the General Appropriation Act of 2004 (Act 7A).
[Pa.B. Doc. No. 04-1790. Filed for public inspection September 24, 2004, 9:00 a.m.]
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