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PA Bulletin, Doc. No. 09-588

NOTICES

Payment for State Veterans' Homes; Notice of Change in Methods and Standards of Setting Payment Rates

[39 Pa.B. 1594]
[Saturday, March 28, 2009]

   The purpose of this notice is to announce that the Department of Public Welfare (Department) is proposing to amend the Commonwealth's Title XIX State Plan provisions to change the methods and standards for payments to State veterans' homes for Medical Assistance (MA) nursing facility services beginning April 1, 2009.

   Currently, the Department determines the MA allowable costs and MA payment rates for State veterans' homes in accordance with the same provisions in the Commonwealth's approved State Plan that apply to State aftercare facilities operated by the Department. The Department receives Federal matching funds to cover a portion of the MA payments made to State veterans' homes.

   The Department intends to establish a separate payment methodology for State veterans' homes effective April 1, 2009. This methodology will recognize the costs incurred by State veterans' homes to provide nursing facility services to MA eligible residents as MA Program expenditures, so long as the costs are allowable under the Department's approved State Plan and the costs are reported and certified by the State veterans' home in a form and manner specified by the Department.

   To identify allowable costs, State veterans' homes will use the Medicare Provider Reimbursement Manual (CMS Pub. 15-1). The Department may specify additional allowable costs for state veterans' homes that are not allowable under the CMS Pub. 15-1, but are allowable in Attachment 4.19D, Part Ia, of the Commonwealth's State Plan.

   After the close of the State veterans' home cost report period, each State veterans' home will submit a Pennsylvania specific cost report in accordance with cost reporting instructions. The State veterans' home's Pennsylvania specific cost report will be audited and the facility's audited MA allowable costs will be certified by the Department as MA allowable expenditures to the Federal Centers for Medicare & Medicaid Services (CMS) as qualifying for Federal matching funds. The Department will compare each State veterans' home's total audited allowable MA rate year costs with each State veterans' home's interim MA payments for the rate year and reconcile the costs and payments based on the method agreed upon by the Department and the State veterans' homes.

   To authorize this payment methodology for State veterans' homes the Department will submit a State Plan Amendment (SPA) to the CMS. Implementation of the proposed changes is contingent upon approval of the SPA by CMS.

Fiscal Impact

   No fiscal impact will result from the establishment of the revised payment methodology for State veterans' homes.

Public Comment

   Interested persons are invited to submit written comments regarding the contents of this notice to Gail Weidman, Department of Public Welfare, Office of Long-Term Living, 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 Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

ESTELLE B. RICHMAN,   
Secretary

   Fiscal Note: 14-NOT-593. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 09-588. Filed for public inspection March 27, 2009, 9:00 a.m.]


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