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PA Bulletin, Doc. No. 07-851

NOTICES

Medical Assistance Program Fee Schedule Revision; Change to Conversion Factor for Anesthesia Services

[37 Pa.B. 2257]
[Saturday, May 12, 2007]

   The Department of Public Welfare (Department) will adjust the conversion factor applied in the payment methodology for anesthesia services on the Medical Assistance (MA) Program fee schedule. The changes are effective with dates of service on and after May 21, 2007.

Methodology

   Since June 2004, the Department has used a payment methodology to establish fees for anesthesia services that conforms to the Medicare payment methodology and was developed in consultation with the Pennsylvania Medical Society and the Pennsylvania Society of Anesthesiologists. Fees are established using the following pricing formula: (base unit assigned to each procedure code × conversion factor) + (conversion factor × time units). For select obstetrical anesthesia services (procedure codes 01960, 01961, 01962, 01963 and 01967), the Department uses the same pricing formula but adjusts the base units by adding four units to the Medicare base units, to account for the particular manner in which these services are provided.

   The Department has applied the 2004 Pennsylvania-specific Medicare conversion factor to the pricing formula since June 2004. The Center for Medicare and Medicaid Services adjusted the Pennsylvania-specific Medicare conversion factor for 2007, to $15.66. The Department will apply this 2007 Medicare conversion factor to claims for services rendered on and after May 21, 2007. The pricing formula will otherwise remain the same.

Fiscal Impact

   Although this change will be implemented effective May 21, 2007, due to payment lags it is anticipated there will be no fiscal impact in Fiscal Year (FY) 2006-2007. Annual savings from the reduced conversion factor are projected at $0.839 million ($0.400 million in State funds) in the Medical Assistance-Outpatient Program in FY 2007-2008.

Public Comment

   Interested persons are invited to submit written comments regarding this notice to the Department at the following address: Department of Public Welfare, Office of Medical Assistance Programs, c/o Deputy Secretary's Office, Attention: Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments received will be reviewed and considered for any subsequent adjustments to the conversion factor.

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

ESTELLE B. RICHMAN,   
Secretary

   Fiscal Note: 14-NOT-505. No fiscal impact; (8) recommends adoption. Implementation of this notice is anticipated to save $400,000 annually starting in FY 2007-2008.

[Pa.B. Doc. No. 07-851. Filed for public inspection May 11, 2007, 9:00 a.m.]


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