NOTICES
DEPARTMENT OF
HUMAN SERVICES
Disproportionate Share Payments
[48 Pa.B. 3823]
[Saturday, June 23, 2018]The Department of Human Services (Department) is announcing its intent to allocate funding for Fiscal Year (FY) 2017-2018 disproportionate share hospital (DSH) payments to certain Medical Assistance (MA) enrolled acute care general hospitals that participate in an academic medical program.
The Department previously published notice of its intent to allocate funding for these DSH payments at 48 Pa.B. 1784 (March 24, 2018). Although the fiscal impact section in the notice correctly identified the amounts of the Department's allocation, the qualifying criteria have changed. The revised qualifying criteria are described as follows.
Qualifying Criteria
For a hospital to qualify for this DSH payment, it must meet all of the following criteria:
a) The hospital is enrolled in the MA Program as an acute care general hospital and licensed to provide inpatient obstetrical and neonatal services as reported by the Department of Health for the period from July 1, 2014, through June 30, 2015.
b) The hospital is located in a county with a population of less than 100,000 persons, based on the 2010 Census.
c) The hospital is accredited as an adult Level I Trauma Center by the Pennsylvania Trauma System Foundation during FY 2016-2017.
d) The hospital's ratio of total MA inpatient discharges to total inpatient discharges exceeds 20.0%, based on its State FY 2013-2014 MA-336 Hospital Cost Report available to the Department as of March 2018.
e) The hospital's ratio of MA revenue to net patient revenue exceeds 13.0%, based on the Pennsylvania Health Care Cost Containment Council's Financial Analysis 2015, Volume One.
Hospital Payment Determination
The determination of a hospital's payment amount for this class of DSH payments has not changed, except with respect to the source of the data used for the determination. A hospital's payment amount will be determined by the following:
1) Divide the hospital's MA inpatient discharges by the total MA inpatient discharges for all qualifying hospitals.
2) Multiply that share by the total amount allocated for these payments.
The data used for purposes of this determination will be obtained from the FY 2013-2014 MA-336 Hospital Cost Report.
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 2017-2018 impact, as a result of these payments, is $7.265 million ($3.500 million in State general funds and $3.765 million in Federal funds) upon approval by the Centers for Medicare & Medicaid Services.
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. The Department will review and consider all comments received within 30 days in determining the final payment methodology for these 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).
TERESA D. MILLER,
SecretaryFiscal Note: 14-NOT-1250. (1) General Fund; (2) Implementing Year 2017-18 is $3,500,000; (3) 1st Succeeding Year 2018-19 through 5th Succeeding Year 2022-23 are $0; (4) 2016-17 Program—$21,181,000; 2015-16 Program—$17,431,000; 2014-15 Program—$17,431,000; (7) MA—Academic Medical Centers; (8) recommends adoption. Funds have been included in the budget to cover this increase.
[Pa.B. Doc. No. 18-975. Filed for public inspection June 22, 2018, 9:00 a.m.]
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