NOTICES
DEPARTMENT OF
PUBLIC WELFARE
Trauma Disproportionate Share Payments
[39 Pa.B. 1068]
[Saturday, February 21, 2009]Purpose of Notice
The Department of Public Welfare (Department) is announcing its intent to amend the payment methodology and the funding available for an additional class of disproportionate share hospital (DSH) payments to hospitals that are accredited by the Pennsylvania Trauma System Foundation (Foundation) as trauma centers.
Level I and Level II Trauma Centers
The Department will allocate 90% of the total available funds to hospitals accredited as Level I and Level II trauma centers by the Foundation. Fifty percent of this amount available for Level I and Level II trauma centers will be distributed equally among Level I and Level II trauma centers. Fifty percent of the total amount available for Level I and Level II trauma centers will be distributed on the basis of each trauma center's percentage of Medical Assistance (MA) and uninsured ''Pennsylvania Trauma Outcome Study'' (PTOS) trauma cases and patient days compared to the Pennsylvania Statewide total number of MA and uninsured PTOS trauma cases and patient days for Level I and Level II trauma centers. For these payments, the Department will calculate payment to each qualifying hospital accredited as a Level I or Level II trauma center using PTOS data provided by the Foundation. For purposes of calculating the hospital specific portion of the payment, the Department shall count all MA days, uninsured PTOS trauma cases and patient days, irrespective of the home state of the patient.
The Department may use any funds available for trauma disproportionate share payments to make these payments, including any balance of unpaid Level III funds.
West Virginia University Hospital (WVUH) shall be treated as an in-State hospital for purposes of determining WVUH's eligibility for (including its accreditation status) and calculation of the amount of Trauma DSH payments. WVUH data reported to the Foundation shall be included in the previously referenced Pennsylvania Statewide data sets to the extent that WVUH is eligible for payments.
Level III Trauma Centers
A hospital must be accredited by the Foundation as a Level III trauma center to qualify for these DSH payments. The Foundation will accredit Level III trauma centers in accordance with established standards, based upon the guidelines for Level III trauma centers as defined by the American College of Surgeons. In addition to the established standards a hospital shall meet all of the following criteria to qualify for Level III accreditation:
(1) Provide comprehensive emergency services.
(2) Have, on an annual basis, at least 4,000 inpatient admissions from its emergency department.
(3) Be located in a county without an accredited Level I or Level II trauma center.
(4) Not be located within 25 miles travel distance from a Level I or Level II trauma center.
The Department will allocate the 10% of the total available funds to hospitals accredited as Level III trauma centers. Fifty percent of this amount available for Level III trauma centers will be distributed equally among Level III trauma centers. Fifty percent of the total amount available for Level III trauma centers will be distributed on the basis of each trauma center's percentage of MA and uninsured PTOS trauma cases and patient days compared to the Pennsylvania Statewide total number of MA and uninsured PTOS trauma cases and patient days for Level III trauma centers. For these payments, the Department will calculate payment to each qualifying hospital accredited as a Level III trauma center using PTOS data provided by the Foundation. For purposes of calculating the hospital specific portion of the payment, the Department shall count all MA days, uninsured PTOS trauma cases and patient days, irrespective of the home state of the patient. Payment to each qualifying Level III trauma center may not be greater than 50% of the average Statewide annual payment to a Level II trauma center.
The State General Funds available for these payments will be $11.597 million.
Fiscal Impact
The Fiscal Year 2008-2009 fiscal impact, as a result of this additional class of DSH payments is $25.438 million ($11.597 million in State funds).
Public Comment
Interested persons are invited to submit written comments regarding this notice to the Department of Public Welfare, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. 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,
SecretaryFiscal Note: 14-NOT-581. (1) General Fund; (2) Implementing Year 2008-09 is $11.597M; (3) 1st Succeeding Year 2009-10 is $12.337M; 2nd Succeeding Year 2010-11 is $12.337M; 3rd Succeeding Year 2011-12 is $12.337M; 4th Succeeding Year 2012-13 is $12.337M; 5th Succeeding Year 2013-14 is $12.337M; (4) 2007-08 Program $12.5M; 2006-07 Program $12.5M; 2005-06 Program $12.5M; (7) Trauma Centers; (8) recommends adoption. Funds have been included in the budget to cover this increase.
[Pa.B. Doc. No. 09-328. Filed for public inspection February 20, 2009, 9:00 a.m.]
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