NOTICES
DEPARTMENT OF
HUMAN SERVICES
New Class of Disproportionate Share Hospital Payments
[45 Pa.B. 3288]
[Saturday, June 20, 2015]The Department of Human Services (Department) is announcing its intent to create a new class of disproportionate share hospital (DSH) payments for qualifying Medical Assistance (MA) enrolled acute care general hospitals which provide a high volume of inpatient services to MA eligible and low income populations. This payment is intended to promote access to medically necessary inpatient services for MA eligible persons.
Qualifying Criteria
For a hospital to qualify for this class of DSH payment, it must meet all of the following proposed criteria, based on its State Fiscal Year (FY) 2011-2012 MA-336 Hospital Cost Report unless otherwise specified:
(a) The hospital is enrolled in the MA Program as an acute care general hospital.
(b) The hospital is located in a county with a total population of less than 500,000 residents, based on the 2010 Federal decennial census.
(c) The hospital has at least 400 total setup and staffed beds.
(d) The hospital ranked at or above the 90th percentile, among MA enrolled acute care hospitals located in counties with a total population of less than 500,000 residents, on the total number of MA inpatient days of care provided.
(e) The hospital ranked in excess of one standard deviation above the mean among MA enrolled acute care hospitals located in counties with a total population of less than 500,000 residents, on the ratio of MA psychiatric inpatient days provided to total psychiatric inpatient days.
(f) The hospital's ratio of uncompensated care to net patient revenue, based on the Pennsylvania Health Care Cost Containment Council Financial Analysis 2013, exceeded 3.4%.
Payment Determination
The Department intends to pay each qualifying hospital a proportionate amount of the funding allocated to this payment based on the hospital's ratio of MA inpatient days to the total MA inpatient days for all qualifying hospitals. The hospital's ratio is multiplied by the total amount allocated for these payments to determine its payment amount. The data used for purposes of this determination will be based on the FY 2011-2012 PA MA-336 Hospital Cost Report.
Fiscal Impact
The FY 2014-2015 impact is $0.724 million ($0.349 million in State general funds).
Public Comment
Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, 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 in establishing the final edits and methodologies for this new class of DSH payments.
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).
THEODORE DALLAS,
SecretaryFiscal Note: 14-NOT-958. (1) General Fund; (2) Implementing Year 2014-15 is $349,000; (3) 1st Succeeding Year 2015-16 through 5th Succeeding Year 2019-20 are $0; (4) 2013-14 Program—$163,862,000; 2012-13 Program—$268,112,000; 2011-12 Program—$325,685,000; (7) MA—Inpatient; (8) recommends adoption. Funds have been included in the budget to cover this increase.
[Pa.B. Doc. No. 15-1173. Filed for public inspection June 19, 2015, 9:00 a.m.]
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