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PA Bulletin, Doc. No. 11-119

NOTICES

Additional Class of Disproportionate Share Payments

[41 Pa.B. 564]
[Saturday, January 22, 2011]

 The Department of Public Welfare (Department) is announcing its intent to establish an additional class of disproportionate share hospital (DSH) payments to certain qualifying acute care general hospitals that provide a high volume of Medical Assistance (MA) acute care and psychiatric services and incur significant uncompensated care costs. The Department intends for these payments to promote the hospitals' continued participation in the MA Program.

 The Department intends to consider a hospital eligible for this additional class of disproportionate share payments if the hospital meets all of the following criteria, based on the Fiscal Year (FY) 2002-2003 MA Cost Report, unless otherwise specified:

 a) The hospital is enrolled in the MA Program as an acute care general hospital with an excluded psychiatric unit.

 b) The hospital provides MA inpatient days of care in excess of the 85th percentile of MA inpatient days provided by all enrolled acute care general hospitals with an excluded psychiatric unit.

 c) The hospital's number of MA admissions exceeds the 85th percentile of MA admissions of all enrolled acute care general hospitals with an excluded psychiatric unit.

 d) The hospital provides inpatient psychiatric days of care to MA recipients in this Commonwealth in excess of the 90th percentile of the days provided by all enrolled acute care general hospitals with an excluded psychiatric unit.

 e) The hospital's percentage of uncompensated care to net patient revenue exceeds the 90th percentile of this percentage for all enrolled acute care general hospitals with an excluded psychiatric unit according to the Pennsylvania Health Care Cost Containment Council (PHC4) Financial Analysis 2004.

 f) The hospital's operating margin is less than the 15th percentile of the operating margins of all enrolled acute care general hospitals with an excluded psychiatric unit according to the PHC4 Financial Analysis 2004.

 The Department intends to proportionately divide payments between qualified hospitals based on the percentage of each qualifying hospital's MA inpatient days to total MA inpatient days of all qualifying hospitals. In making these payments, the Department will ensure that no acute care general hospital will receive any DSH payment that is in excess of its hospital-specific limit and the Commonwealth will not exceed its aggregate annual DSH allotment.

Fiscal Impact

 The FY 2010-2011 fiscal impact of this additional class of DSH payments is $2.254 million ($1.000 million in State General 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).

MICHAEL P. NARDONE, 
Acting Secretary

 Fiscal Note: 14-NOT-681. (1) General Fund; (2) Implementing Year 2010-2011 is $1,000,000; (3) 1st Succeeding Year 2011-12 is $0; 2nd Succeeding Year 2012-13 is $0; 3rd Succeeding Year 2013-14 is $0; 4th Succeeding Year 2014-15 is $0; 5th Succeeding Year 2015-16 is $0; (4) 2007-08 Program—$21,175,000; 2008-09 Program—$22,580,000; 2009-10 Program—$3,955,000; (7) Acute Care Hospitals; (8) recommends adoption. The Acute Care Hospitals appropriation is able to absorb the increased cost.

[Pa.B. Doc. No. 11-119. Filed for public inspection January 21, 2011, 9:00 a.m.]


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