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PA Bulletin, Doc. No. 14-1055

NOTICES

Medical Assistance Reliant Hospital Supplemental Payment

[44 Pa.B. 2948]
[Saturday, May 17, 2014]

 The Department of Public Welfare (Department) is providing final notice of its implementation of supplemental payments to certain acute care general hospitals that provide a large portion of their inpatient services to Pennsylvania (PA) Medical Assistance (MA) consumers. These hospitals provide critical services to the MA population as well as to uninsured individuals and they rely almost entirely on MA revenue for their ongoing operations.

Background

 Hospitals with a patient population consisting mainly of MA consumers provide access to hospital services that otherwise may not be available to these individuals. To promote the continued participation in the MA Program and the provision of needed services to the MA population by these hospitals, the Department is making supplemental payments to these facilities.

 To qualify for the supplemental payments, a hospital enrolled in the PA MA Program as an acute care general hospital must provide at least 80% of its inpatient days of care to PA MA (managed care and fee-for-service) consumers as evidenced by the hospitals' Fiscal Year (FY) 2009-2010 MA cost report (MA 336).

 Payments are divided proportionately among qualifying hospitals based on the percentage of each qualifying hospital's PA MA inpatient days to the total PA MA inpatient days for all qualifying hospitals. All payment limitations are still applicable, including that payments to a qualifying hospital may not exceed its hospital specific limit as defined by section 1923 of the Social Security Act (42 U.S.C.A. § 1396r-4).

 The Department published notice of its intent to establish this supplemental payment at 43 Pa.B. 5538 (September 14, 2013). The Department received no public comments during the 30-day comment period and will implement the changes as described in its notice of intent.

Fiscal Impact

 The FY 2013-2014 impact, as a result of the funding allocation for these payments is $0.300 million ($0.139 million in State general funds and $0.161 million in Federal funds upon approval by the Centers for Medicare and Medicaid Services).

BEVERLY D. MACKERETH, 
Secretary

 Fiscal Note: 14-NOT-872. (1) General Fund; (2) Implementing Year 2013-14 is $139,000; (3) 1st Succeeding Year 2014-15 is $0; 2nd Succeeding Year 2015-16 is $0; 3rd Succeeding Year 2016-17 is $0; 4th Succeeding Year 2017-18 is $0; 5th Succeeding Year 2018-19 is $0; (4) 2012-13 Program—$268,112,000; 2011-12 Program—$325,685,000; 2010-11 Program—$243,809,000; (7) MA—Inpatient; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 14-1055. Filed for public inspection May 16, 2014, 9:00 a.m.]


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