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PA Bulletin, Doc. No. 09-434

NOTICES

DEPARTMENT OF
PUBLIC WELFARE

Additional Class of Disproportionate Share Payments to Qualifying Teaching Hospitals

[39 Pa.B. 1271]
[Saturday, March 7, 2009]

   The purpose of this notice is to announce the Department of Public Welfare (Department) is providing final notice of the establishment of disproportionate share hospital (DSH) payments to qualifying teaching hospitals that provide psychiatric services to Medical Assistance (MA) recipients. Across the Commonwealth there is a shortage of psychiatrists, notably those involved in the public health sector. The Department is working to recruit and retain psychiatrists to work in underserved rural and urban areas throughout the Commonwealth. These DSH payments are intended to help offset the medical education costs of psychiatrists incurred by the hospitals providing psychiatric services to MA recipients and the uninsured.

   The Department previously published notice of its intent to distribute payments to qualifying teaching hospitals as grant payments at 38 Pa.B. 2742 (June 7, 2008). The Department received no public written comments in response to this notice. Upon guidance from the Centers for Medicare and Medicaid Services (CMS) regarding the distribution of these payments as grants, the Department revised the methodology for these payments to establish an additional class of DSH payments.

   The Department will consider any psychiatric unit of a general acute care hospital enrolled in Pennsylvania MA with psychiatric medical education costs that exceed $100,000, according to the Fiscal Year (FY) 2005-2006 MA Cost Report, eligible for this additional class of DSH payments if it meets one of the following criteria:

   1.  The hospital provides at least 40,000 psychiatric days of service to Pennsylvania MA recipients as reported on the FY 2005-06 MA Cost Report.

   2.  The hospital's inpatient psychiatric medical education costs for Pennsylvania MA recipients exceed $500,000 as reported on the FY 2005-06 MA Cost Report.

   3.  The hospital's uncompensated care to net patient revenue is greater than 5.0% as reported by Pennsylvania Health Care Cost Containment Council for Fiscal Year 2007.

   Payments to qualifying teaching hospitals are divided equally among all qualifying teaching hospitals.

   In making these payments, the Department ensures that no acute care general hospital will receive any DSH payment that is in excess of its hospital-specific DSH upper payment limit and the Commonwealth will not exceed its aggregate annual DSH allotment.

Fiscal Impact

   The FY 2008-2009, fiscal impact of this grant program is $0.500 million ($0.228 million in State funds).

ESTELLE B. RICHMAN,   
Secretary

   Fiscal Note: 14-NOT-583. (1) General Fund; (2) Implementing Year 2008-09 is $228,000; (3) 1st Succeeding Year 2009-10 is $228,000; 2nd Succeeding Year 2010-11 is $228,000; 3rd Succeeding Year 2011-12 is $228,000; 4th Succeeding Year 2012-13 is $228,000; 5th Succeeding Year 2013-14 is $228,000; (4) 2007-08 Program--$468,589; 2006-07 Program--$513,020; 2005-06 Program--$474,693; (7) Medical Assistance--Inpatient; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 09-434. Filed for public inspection March 6, 2009, 9:00 a.m.]


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