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PA Bulletin, Doc. No. 17-589

NOTICES

New Class of Disproportionate Share Payments

[47 Pa.B. 2159]
[Saturday, April 8, 2017]

 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 that promote access to comprehensive inpatient services for MA eligible persons by providing an adequate supply of health care professionals, who have been trained in high volume MA enrolled hospital settings.

Qualifying Criteria

 For a hospital to qualify for this DSH payment, it must meet all of the following criteria, based on its State Fiscal Year (FY) 2013-2014 MA-336 Hospital Cost Report available to the Department as of October 2016 unless otherwise specified:

 a) The hospital is enrolled in the MA Program as a general acute care hospital.

 b) The hospital provides acute care, psychiatric and medical rehabilitation services to MA eligible individuals.

 c) The total number of MA inpatient days provided by the hospital exceeded the 99th percentile for all acute care hospitals in FY 2013-2014 in this Commonwealth.

 d) The hospital had more than 700 full-time equivalent residents in programs approved by the Accreditation Council for Graduate Medical Education.

Payment Determination

 The Department will determine a hospital's payment amount for this class of DSH payments by dividing the hospital's MA inpatient days by the total MA inpatient days for all qualifying hospitals and multiplying that percentage by the total amount allocated for these payments. The Department will use data from the FY 2013-2014 MA-336 Hospital Cost Report for this calculation.

 All payment limitations are still applicable, including those limitations that the Commonwealth may not exceed its aggregate annual DSH allotment and that no hospital may receive DSH payments in excess of its hospital specific limit.

Fiscal Impact

 The FY 2016-2017 impact, as a result of the creation of this new class of DSH payments, is $24.745 million ($11.930 million in State general funds and $12.815 million in Federal funds) upon approval by the Centers for Medicare & Medicaid Services.

Public Comment

 Interested persons are invited to submit written comments regarding these payments to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. The Department will review and consider all comments received within 30 days of 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).

THEODORE DALLAS, 
Secretary

 Fiscal Note: 14-NOT-1125. (1) General Fund; (2) Implementing Year 2016-17 is $300,000; (3) 1st Succeeding Year 2017-18 through 5th Succeeding Year 2021-22 are $0; (4) 2015-16 Program—$392,918,000; 2014-15 Program—$564,772,000; 2013-14 Program—$428,041,000; (7) MA—Fee-for-Service; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 17-589. Filed for public inspection April 7, 2017, 9:00 a.m.]


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