NOTICES
Disproportionate Share and Supplemental Hospital Payments
[42 Pa.B. 6047]
[Saturday, September 22, 2012]The Department of Public Welfare (Department) is announcing its intent to allocate funding for Fiscal Year (FY) 2012-2013 for several disproportionate share hospital (DSH) and supplemental hospital payments made to qualifying Medical Assistance (MA) enrolled hospitals.
Background
During FY 2010-2011, 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. Specifically, the Department modified its payment methodologies for inpatient DSH and outpatient DSH supplemental and Direct Medical Education (DME) payments. In addition the Department implemented a new class of DSH payments for small and sole community hospitals and new classes of supplemental payments consisting of MA Dependency payments, MA Rehabilitation adjustment payments, MA Stability payments and Enhanced payments to certain DSHs. The Department is announcing its intended funding allocations for the inpatient DSH and supplemental payment for FY 2012-2013.
Funding Allocations
The funds for these DSH and supplemental payments are allocated from the Commonwealth's FY 2012-2013 budget and the anticipated revenues from the Quality Care Assessment.
Inpatient DSH
For FY 2012-2013, the Department intends to allocate $40.410 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. This intended allocation maintains funding at the same level of funding for inpatient DSH payments as allocated in FYs 2010-2011 and 2011-2012. The Department does not intend to change its approved State Plan provisions addressing the qualifying criteria or payment methodology for these DSH payments.
Outpatient Disproportionate Share Supplemental Payments
For FY 2012-2013, the Department intends to allocate $27.489 million in State general funds for outpatient disproportionate share supplemental payments with the aggregate amount of outpatient disproportionate share supplemental payments not to exceed $60.386 million in total funds. This intended allocation maintains funding for this payment at the same level of funding allocated to these payments for FYs 2010-2011 and 2011-2012. 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 2012-2013, the Department intends to allocate $55.348 million in State general funds for DME payments with the aggregate amount of the DME payments not to exceed $121.585 million in total funds. This intended allocation maintains DME funding at the same level of funding allocated to DME payments for FYs 2010-2011 and 2011-2012. 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 2012-2013, the Department intends to allocate $151.444 million ($69.240 million in State general funds) for these supplemental payments. This intended allocation maintains funding for this payment at the same level of funding allocated to MA Stability payments for FYs 2010-2011 and 2011-2012. 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 2012-2013, the Department intends to allocate $11.564 million ($5.287 million in State general funds) for these supplemental payments. This intended allocation maintains funding for MA Dependency payments at the same level of funding allocated to these payments for FYs 2010-2011 and 2011-2012. 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 2012-2013, the Department intends to allocate $18.619 million ($8.513 million in State general funds) for these supplemental payments. This intended allocation maintains funding for this payment at the same level of funding allocated to the MA Rehabilitation Adjustment Payments for FYs 2010-2011 and 2011-2012. The Department does not intend to change its approved State Plan provisions addressing the qualifying criteria or payment methodology for these supplemental payments.
DSH Payments to Small and Sole Community Hospitals
For FY 2012-2013, the Department intends to allocate $58.893 million ($26.926 million in State general funds) for these DSH payments. This intended allocation maintains funding for this payment at the same level of funding allocated to DSH payments to Small and Sole Community Hospitals for FYs 2010-2011 and 2011-2012. The Department does not intend to change its approved State Plan provisions addressing the qualifying criteria or payment methodology for these DSH payments.
Enhanced Payments to Certain DSHs
For FY 2012-2013, the Department intends to allocate $24.661 million ($11.275 million in State general funds) for these supplemental payments. This intended allocation maintains funding for these enhanced payments at the same level of funding allocated for these payments for FYs 2010-2011 and 2011-2012. 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 2012-2013 fiscal impact, as a result of these payments, is $535.922 million ($244.489 million in State general funds and $291.433 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) 654-5988 (voice users).
GARY D. ALEXANDER,
SecretaryFiscal Note: 14-NOT-793. (1) General Fund:
MA—Inpatient MA—Outpatient (2) Implementing Year 2012-13 is $217,000,000 $27,489,000 (3) 1st Succeeding Year 2013-14 is $0 $0 2nd Succeeding Year 2014-15 is $0 $0 3rd Succeeding Year 2015-16 is $0 $0 4th Succeeding Year 2016-17 is $0 $0 5th Succeeding Year 2017-18 is $0 $0 (4) 2011-12 Program— $325,685,000 $645,095,000 2010-11 Program— $243,809,000 $467,929,000 2009-10 Program— $371,515,000 $435,939,000 (7) MA—Inpatient and MA—Outpatient; (8) recommends adoption. Funds have been included in the budget to cover this increase.
[Pa.B. Doc. No. 12-1871. Filed for public inspection September 21, 2012, 9:00 a.m.]
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