NOTICES
DEPARTMENT OF
PUBLIC WELFARE
Delay in Implementation of Alternative Cost Sharing for Families of Children with Disabilities with Incomes over 200% of the Federal Poverty Income Guidelines
[42 Pa.B. 6838]
[Saturday, October 27, 2012]The Department of Public Welfare (Department) previously published a public notice at 42 Pa.B. 6222 (September 29, 2012) announcing the implementation of copayments for services provided to children eligible for Medical Assistance (MA) under the MA for Children with Special Needs category with family income above 200% of the Federal Poverty Income Guidelines. The copayments were to be effective for dates of service on and after October 1, 2012, for newly eligible beneficiaries and November 1, 2012, for current beneficiaries.
Based upon feedback from families, stakeholders and other interested parties, the Department has decided to delay the implementation of copayments. Families of children eligible for MA under this category of assistance will not owe a copayment for any services until further notice.
Many stakeholders have acknowledged the need for cost sharing in the MA for Children with Special Needs program and have indicated that a premium would be preferred over copayments. The Department agrees, but has been unable to implement premiums because the Centers for Medicare and Medicaid Services (CMS) has taken the position that implementing premiums violates the Maintenance of Effort provisions of the Affordable Care Act. Delaying the implementation of copayments will allow the Department the opportunity to work with stakeholders and to seek approval from CMS to apply premiums or to identify and implement other cost-sharing alternatives. Once a decision has been reached, families will receive advance notice of their cost-sharing requirements.
Fiscal Impact
This delay is anticipated to result in costs of $9.405 million ($4.300 million in State funds) in the MA Outpatient Program in Fiscal Year 2012-2013 and annualized costs of $12.540 million ($5.813 million in State funds) in Fiscal Year 2013-2014.
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 Deputy Secretary's Office, Attention: Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments received within 30 days will be reviewed and considered in the development of subsequent notice. Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
GARY D. ALEXANDER,
SecretaryFiscal Note: 14-NOT-799. (1) General Fund; (2) Implementing Year 2012-13 is $4,300,000; (3) 1st Succeeding Year 2013-14 is $5,813,000; 2nd Succeeding Year 2014-15 is $5,813,000; 3rd Succeeding Year 2015-16 is $5,813,000; 4th Succeeding Year 2016-17 is $5,813,000; 5th Succeeding Year 2017-18 is $5,813,000; (4) 2011-12 Program—$645,095,000; 2010-11 Program—$467,929,000; 2009-10 Program—$435,939,000; (7) MA—Outpatient; (8) recommends adoption. The MA—Outpatient appropriation is able to absorb the increased cost.
[Pa.B. Doc. No. 12-2112. Filed for public inspection October 26, 2012, 9:00 a.m.]
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