NOTICES
DEPARTMENT OF
PUBLIC WELFARE
Additional Class of Payments to Qualifying Acute Care General Hospitals for Obstetrical and Neonatal Intensive Care Services
[39 Pa.B. 2859]
[Saturday, June 6, 2009]Purpose
This notice announces that the Department of Public Welfare (Department) is providing final notice of the allocation of funding for Fiscal Year (FY) 2008-2009 for an additional class of disproportionate share hospital (DSH) payments for certain qualifying hospitals based on obstetrical and neonatal intensive care cases. The Department amended the payment methodology applicable to rural hospitals for these DSH payments. There is no change to the qualifying criteria for determining eligibility for these payments or the payment methodology for nonrural hospitals.
The Department published notice of its intent to allocate funding and amend the payment methodology applicable to rural hospitals for an additional class of DSH payment for certain qualifying hospitals based on obstetrical and neonatal intensive care cases at 39 Pa.B. 1362 (March 14, 2009). The Department received no public comments during the 30-day public comment period.
The payment methodology for rural hospitals that meet the qualifying criteria is:
(a) 15% of the total amount available will be paid to qualified rural hospitals as follows:
(i) Of the amount available for distribution to rural hospitals, 75% will be distributed to qualified rural hospitals with obstetrical cases for Pennsylvania (PA) Medical Assistance (MA) recipients using the following formula:
(A) For each hospital, determine the ratio of the hospital's obstetrical cases for PA MA recipients to all obstetrical cases for the hospital.
(B) For each hospital, multiply the ratio under clause (A) by the number of the hospital's obstetrical cases for PA MA recipients.
(C) Add the products under clause (B) for all hospitals.
(D) Divide the amount available for distribution to rural hospitals by the sum under clause (C).
(E) Multiply the quotient under clause (D) by the product under clause (B).
(F) For rural hospitals located in counties whose ratio of MA eligible persons to total county population exceeds one standard deviation above the mean for all rural counties but less than 1.3 standard deviations above the mean for all rural counties, multiply the product in clause (E) by 1.50. For rural hospitals located in counties whose ratio of MA eligible persons to total county population is equal to or greater than 1.3 standard deviations above the mean for all rural counties but less than 1.6 standard deviations above the mean for all rural counties, multiply the product in clause (E) by 1.75. For rural hospitals located in counties whose ratio of MA eligible persons to total county population is equal to or greater than 1.6 standard deviations above the mean for all rural counties, multiply the product in clause (E) by 2.0.
(ii) Of the amount available for distribution to rural hospitals, 10% will be distributed to qualified rural hospitals with neonatal intensive-care cases for PA MA recipients using the following formula:
(A) For each hospital, determine the ratio of the hospital's neonatal intensive care cases for PA MA recipients to all neonatal intensive care cases for the hospital.
(B) For each hospital, multiply the ratio under clause (A) by the number of the hospital's neonatal intensive care cases for PA MA recipients.
(C) Add the products under clause (B) for all hospitals.
(D) Divide the amount available for distribution to rural hospitals by the sum under clause (C).
(E) Multiply the quotient under clause (D) by the product under clause (B).
(F) For rural hospitals located in counties whose ratio of MA eligible persons to total county population exceeds one standard deviation above the mean for all rural counties but less than 1.3 standard deviations above the mean for all rural counties, multiply the product in clause (E) by 1.50. For rural hospitals located in counties whose ratio of MA eligible persons to total county population is equal to or greater than 1.3 standard deviations above the mean for all rural counties but less than 1.6 standard deviations above the mean for all rural counties, multiply the product in clause (E) by 1.75. For rural hospitals located in counties whose ratio of MA eligible persons to total county population is equal to or greater than 1.6 standard deviations above the mean for all rural hospitals, multiply the product in clause (E) by 2.0.
(iii) 15% of the funds available for rural hospitals will be distributed equally among qualified rural hospitals with obstetrical cases for PA MA recipients.
(iv) To ensure that payments do not exceed available funds, the Department may adjust payments to each hospital to receive its proportionate share of the available funds.
In making these payments, the Department ensures that no acute care general hospital receives 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 related to these payments is $14.389 million ($6.544 million in State funds). This will be treated as a one-time only payment.
ESTELLE B. RICHMAN,
SecretaryFiscal Note: 14-NOT-602. (1) General Fund; (2) Implementing Year 2008-09 is $6,544,000; (3) 1st Succeeding Year 2009-10 is $0; 2nd Succeeding Year 2010-11 is $0; 3rd Succeeding Year 2011-12 is $0; 4th Succeeding Year 2012-13 is $0; 5th Succeeding Year 2013-14 is $0; (4) 2007-08 Program--$5,000,000; 2006-07 Program--$0; 2005-06 Program--$0; (7) MA--Obstetric and Neonatal Services; (8) recommends adoption. Funds have been included in the budget to cover this increase.
[Pa.B. Doc. No. 09-1033. Filed for public inspection June 5, 2009, 9:00 a.m.]
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