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PA Bulletin, Doc. No. 06-2071

NOTICES

Payments to County Nursing Facilities; Proposed Rates for State Fiscal Year 2006-2007

[36 Pa.B. 6474]
[Saturday, October 21, 2006]

   This notice announces the Department of Public Welfare's (Department) proposed annual rates for State Fiscal Year 2006-2007 (FY 06-07), for county nursing facilities that participate in the Medical Assistance (MA) Program.

   The rates will be calculated in accordance with 55 Pa. Code Chapter 1189, Subchapter D (relating to rate setting). As stated at 55 Pa. Code § 1189.91(a) (relating to per diem rates for county nursing facilities), the per diem rate paid to a county nursing facility for a rate year will be the facility's April 1, 2006, case-mix per diem rate as calculated under 55 Pa. Code Chapter 1187, Subchapter G (relating to rate setting) multiplied by a budget adjustment factor (BAF). The per diem rates for the quarter that began on April 1, 2006, were previously announced at 36 Pa.B. 1300 (March 18, 2006).

   As required by 55 Pa. Code § 1189.91(d), the Department intends to follow the formula set forth in the Commonwealth's approved State Plan to determine the BAF for FY 06-07. The Department recently submitted State Plan Amendments 06-008 and 06-009 to the Federal Centers for Medicare and Medicaid Services to include, among other things, the BAF formula which the Department will use in FY 06-07. As set forth in Supplement III to SPA 06-008, the Department completed these steps to determine the BAF for county nursing facilities:

   Step 1:  The Department determined the total appropriated funds that will be allocated for MA payments to county nursing facilities for the 2006-2007 rate year as follows:

   1.  Each county nursing facility's projected MA days for the rate year were multiplied by the facility's April 1, 2006, MA per diem rate to obtain each facility's projected payments for the rate year.

   2.  The projected payments for all county nursing facilities were added to obtain the total projected county payments for the rate year.

   3.  Each nonpublic nursing facility's projected MA days were multiplied by the facility's April 1, 2006, MA per diem rate to obtain each facility's projected payments for the rate year.

   4.  The projected payments for all nonpublic nursing facilities were added to obtain the total projected nonpublic payments for the rate year.

   5.  The total projected county and the total projected nonpublic payments were added to obtain the Statewide total projected payments for all nursing facilities for the rate year.

   6.  The total projected county payments were divided by the Statewide total projected payments to obtain the county projected payment percentage.

   7.  The county projected payment percentage was multiplied by the total funds appropriated in the General Appropriations Act for MA nursing facility services for the rate year to determine the total appropriated funds allocated to county nursing facilities.

   Step 2:  The BAF for county nursing facilities was determined as follows:

   The total allocated funds for county nursing facilities determined in Step 1-7 was added to the projected patient pay amount for county nursing facilities for the rate year and that amount was divided by the total projected county payments for the rate year as determined in Steps 1-1 through 1-2 to determine the budget adjustment factor to be used for the rate year.

   Using the BAF formula set forth in the pending State Plan Amendments, the budget adjustment factor for county nursing facilities for FY 06-07 will be 1.04.

   The proposed per diem rates for FY 06-07 are available on the website for the Office of Medical Assistance Programs at www.dpw.state.pa.us/omap and at local county assistance offices throughout this Commonwealth or by contacting Tom Jayson, Policy Unit, Bureau of Long Term Living Support at (717) 705-3705.

Fiscal Impact

   The change in county nursing facility payment rates, effective July 1, 2006, is estimated to cost the Department $23.704 million ($10.772 million in State funds) in FY 06-07.

Public Comment

   Interested persons are invited to submit written comments regarding the proposed rates for FY 06-07 or the BAF formula, to the Department at the following address: Department of Public Welfare, Bureau of Long-Term Living Support, Attention: Gail Weidman, P. O. Box 2675, Harrisburg, PA 17105. Comments received within 30 days will be reviewed and considered for any subsequent revision of the notice.

   Persons with a disability who require an auxiliary aid or service may submit comments using the AT&T Relay Services at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

ESTELLE B. RICHMAN,   
Secretary

   Fiscal Note:  14-NOT-488. (1) General Fund; (2) Implementing Year 2006-07 is $10,772,000; (3) 1st Succeeding Year 2007-08 is $11,752,000; 2nd Succeeding Year 2008-09 is $11,752,000; 3rd Succeeding Year 2009-10 is $11,752,000; 4th Succeeding Year 2010-11 is $11,752,000; 5th Succeeding Year 2011-12 is $11,752,000; (4) 2005-06 Program--$817,890,000; 2004-05 Program--$476,116,000; 2003-04 Program--$588,528,000; (7) Medical Assistance--Long-Term Care; (8) recommends adoption. Funds have been included in the current budget to cover the increase.

[Pa.B. Doc. No. 06-2071. Filed for public inspection October 20, 2006, 9:00 a.m.]


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