NOTICES

DEPARTMENT OF
PUBLIC WELFARE

Changes to an Additional Class of Disproportionate Share Payments

[39 Pa.B. 1452]
[Saturday, March 21, 2009]

   The Department of Public Welfare (Department) is providing final notice of its revision to the criteria and an increase in the allocation for disproportionate share hospital (DSH) payments to certain qualifying Medical Assistance (MA) enrolled hospitals for Fiscal Year (FY) 2007-2008.

   The Department published notice of its intent to revise the qualifying criteria for DSH payments to hospitals that advanced the Department's goal of enhanced access to multiple types of medical care in economically distressed areas of this Commonwealth and to increase its allocation for this payment at 38 Pa.B. 2741 (June 7, 2008). The Department received no public comments during the 30 day public comment period.

   To address increases in MA eligibility and service costs and to ensure access to care for MA recipients, the Department will change the original qualifying criteria and will provide a one-time increase to its allocation.

   The Department has adopted the criteria set forth in its notice of intent and will consider a hospital eligible, provided it is an acute care general hospital that meets all of the following criteria:

   (a)  The hospital provides in excess of 100,000 inpatient days to MA eligible individuals as reported on its FY 2004-2005 MA Hospital Cost Report (MA 336).

   (b)  The hospital has a Low-Income Utilization Rate in excess of the 95th percentile of the Low-Income Utilization Rate for all enrolled acute care general hospitals as reported on its FY 2004-2005 MA Hospital Cost Report (MA 336).

   (c)  The hospital's ratio of MA revenue to net patient revenue exceeds the 98th percentile for all Commonwealth acute care general hospitals as reported in the Pennsylvania Health Care Cost Containment Council's 2006 Financial Analysis, Volume One.

   (d)  The dollar value of the hospital's uncompensated care equals or exceeds the 94th percentile of the value to uncompensated care for all acute care general hospitals as reported in the Pennsylvania Health Care Cost Containment Council's 2006 Financial Analysis, Volume One.

   (e)  The hospital is located in a Census tract designated by the Bureau of Primary Health Care of the Health Resource and Services Administration as a Medically Underserved Area.

   For FY 2007-2008 only, the Department will increase the amount allocated for this payment from $5.862 million to $11.348 million. The Department is not changing its methodology of calculating payment for qualifying hospitals. In making these payments, the Department continues to ensure that no acute care general hospital receives a 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

   For FY 2007-2008, the fiscal impact as a result of the revision to the criteria and the one-time payment increase in DSH payment allotment is $11.949 million in total funds ($5.486 million in State General Funds and $6.463 million in Federal funds).

ESTELLE B. RICHMAN,   
Secretary

   Fiscal Note: 14-NOT-586. (1) General Fund:

MA--Inpatient
	(2)  Implementing Year 2007-08 is	$1.986 M
	(3)  1st Succeeding Year 2008-09 is	$0.000 M
	2nd Succeeding Year 2009-10 is	$0.000 M
	3rd Succeeding Year 2010-11 is	$0.000 M
	4th Succeeding Year 2011-12 is	$0.000 M
	5th Succeeding Year is 2012-13 is	$0.000 M
		Acute Care Hospitals
	Implementing Year 2007-08 is	$3.500 M
	1st Succeeding Year 2008-09 is	$0.000 M
	2nd Succeeding Year 2009-10 is	$0.000 M
	3rd Succeeding Year 2010-11 is	$0.000 M
	4th Succeeding Year 2011-12 is	$0.000 M
	5th Succeeding Year 2012-13 is	$0.000 M

MA--Inpatient
	(4) 2006-07 Program	$513.020 M
	2005-06 Program	$474.693 M
	2004-05 Program	$531.785 M
		Acute Care Hosptials:
	2006-07 Program	$14.500 M
	2005-06 Program	$10.800 M
	2004-05 Program	$12.200 M

(7)  Medical Assistance (MA)--Inpatient; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 09-540. Filed for public inspection March 20, 2009, 9:00 a.m.]

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