NOTICES
Disproportionate Share and Supplemental Hospital Payments
[41 Pa.B. 5245]
[Saturday, October 1, 2011]The Department of Public Welfare (Department) is announcing its intent to allocate funding for several disproportionate share hospital (DSH) and supplemental hospital payments made to qualifying Medical Assistance (MA) enrolled hospitals.
Background
The Department implemented modifications to certain existing DSH and supplemental payments and established several new DSH and supplemental payments to hospitals using revenues from the Quality Care Assessment Account. The Department published a notice describing its intended changes at 40 Pa.B. 5536 (September 25, 2010). Specifically, the Department modified its methodologies for the payment of Inpatient DSH and Direct Medical Education (DME). The Department also implemented a new class of DSH payments for small and sole-community hospitals and new classes of supplemental payments including MA Dependency payments, MA Rehabilitation Adjustment payments, MA Stability payments and Enhanced Payments to Certain Disproportionate Share Hospitals. CMS approved the State Plan Amendment (SPA) authorizing these payments and their payment methodologies on December 29, 2010.
Funding Allocations
The funds for these DSH and supplemental payments are allocated from the Commonwealth's Fiscal Year (FY) 2011-2012 budget and the anticipated revenues from the Quality Care Assessment.
Inpatient DSH
For FY 2011-2012, the Department intends to allocate $39.774 million in State General Funds for inpatient DSH with the aggregate amount of inpatient DSH payments not to exceed $88.769 million in total funds. The Department does not intend to change its approved State Plan provisions addressing the qualifying criteria or payment methodology for these DSH payments.
Outpatient DSH
For FY 2011-2012, the Department intends to allocate $27.045 million in State General Funds for outpatient DSH with the aggregate amount of outpatient DSH payments not to exceed $60.386 million in total funds. The Department does not intend to change its approved State Plan provisions addressing the qualifying criteria or payment methodology for these payments.
DME Payments
For FY 2011-2012, the Department intends to allocate $54.511 million in State General Funds for DME payments with the aggregate amount of DME payments not to exceed $121.585 million in total funds. The Department does not intend to change its approved State Plan provisions addressing the qualifying criteria or payment methodology for these supplemental payments.
MA Stability Payments
For FY 2011-2012, the Department intends to allocate $151.444 million ($68.044 million in State General Funds) for these supplemental payments. The Department does not intend to change its approved State Plan provisions addressing the qualifying criteria or payment methodology for these supplemental payments.
MA Dependency Payments
For FY 2011-2012, the Department intends to allocate $11.564 million ($5.196 million in State General Funds) for these supplemental payments. The Department does not intend to change its approved State Plan provisions addressing the qualifying criteria or payment methodology for these supplemental payments.
MA Rehabilitation Adjustment Payments
For FY 2011-2012, the Department intends to allocate $18.619 million ($8.365 million in State General Funds) for these supplemental payments. The Department does not intend to change its approved State Plan provisions addressing the qualifying criteria for these supplemental payments. If approved, the Department will use the payment methodology in its pending SPA for these payments. The Department published a notice describing its intended change at 41 Pa.B. 3161 (June 18, 2011).
DSH Payments to Small and Sole Community Hospitals
For FY 2011-2012, the Department intends to allocate $58.893 million ($26.461 million in State General Funds) for this additional class of DSH payments. The Department does not intend to change its approved State Plan provisions addressing the qualifying criteria for these DSH payments. If approved, the Department will use the payment methodology in its pending SPA for these payments. The Department published a notice describing its intended change at 41 Pa.B. 3161.
Enhanced Payments to Certain DSHs
For FY 2011-2012, the Department intends to allocate $24.661 million ($11.080 million in State General Funds) for these supplemental payments. The Department does not intend to change its approved State Plan provisions addressing the qualifying criteria or payment methodology for these supplemental payments.
Fiscal Impact
The FY 2011-2012 fiscal impact, as a result of these payments is $535.921 million ($240.476 million in State General Funds and $295.445 million in Federal Funds upon approval by the Centers for Medicare and Medicaid Services).
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 to this 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).
GARY D. ALEXANDER,
SecretaryFiscal Note: 14-NOT-721. (1) General Fund:
MA—Inpatient MA—Outpatient (2) Implementing Year 2011-12 is $213,431,000 $27,045,000 (3) 1st Succeeding Year 2012-13 is $0 $0 2nd Succeeding Year 2013-14 is $0 $0 3rd Succeeding Year 2014-15 is $0 $0 4th Succeeding Year 2015-16 is $0 $0 5th Succeeding Year 2016-17 is $0 $0 (4) 2010-11 Program— $243,809,000 $467,929,000 2009-10 Program— $371,515,000 $435,939,000 2008-09 Program— $426,822,000 $555,085,000 (7) MA—Inpatient and MA—Outpatient; (8) recommends adoption. Funds have been included to cover these increased costs.
[Pa.B. Doc. No. 11-1703. Filed for public inspection September 30, 2011, 9:00 a.m.]
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