NOTICES
DEPARTMENT OF
HUMAN SERVICES
Disproportionate Share Payments and Supplemental Payments for Qualifying Hospitals
[52 Pa.B. 7473]
[Saturday, December 3, 2022]The Department of Human Services (Department) is announcing its intent to update the qualifying criteria and payment methodology for disproportionate share hospital (DSH) and supplemental payments to Medical Assistance enrolled and qualifying emergency departments in acute care general hospitals by adding references to the report used in determining the eligibility for and the payment amounts beginning Fiscal Year 2022-2023.
Payment limitations are 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.
Qualifying Criteria
The qualifying criteria is being updated to reference the report used in determining the number of annual emergency department visits. State Plan Attachment 4.19A, page 21w, 1(c) and Attachment 4.19B, page 4a, 1(c) will be revised to include the underlined language as shown as follows:
1(c) Provides at least 1,000 emergency department visits to Pennsylvania (PA) Medical Assistance (MA) patients per year according to Fiscal Year (FY) 2008-2009 PA Department of Health Reports 1-A, 1-B and 4.
Payment Methodology
The payment methodology is being updated to reference the report used in determining the hospital's net patient value. State Plan Attachment 4.19A, page 21w, 2(a)(ii) and 2(b) will be revised to include the underlined language as shown as follows:
2(a)(ii) 2.91% of the hospital's net patient revenue as determined using net patient revenue as reported within ''Revenue Reporting Form from Hospital Assessment'' on file with the Department.
2(b) If, after calculating the payment amounts in (2)(a), funds remain from the total funds allocated in the FY for these payments, the Department will increase the payment amount of a qualified hospital for which payment was authorized under (a)(i) by an amount equal to the ratio of the hospital's FY 2011-2012 MA Title XIX fee-for-service inpatient revenue to the total FY 2011-2012 MA Title XIX fee-for-service inpatient revenue of all qualified hospitals for which payment was calculated under (a)(i) multiplied by the funds remaining from the total funds allocated in the FY. The total payments made to a qualified hospital pursuant to (2)(a) and (b) shall not exceed 2.91% of the hospital's net patient revenue as determined using net patient revenue as reported within ''Revenue Reporting Form from Hospital Assessment'' on file with the Department.
State Plan Attachment 4.19B, page 4a, 2(a)(ii) and (c)(ii) will be revised to include the underlined language as shown as follows:
2(a)(ii) and 2(c)(ii) 2.91% of the hospital's net patient revenue as determined using net patient revenue as reported within ''Revenue Reporting Form from Hospital Assessment'' on file with the Department.
Fiscal Impact
There is no fiscal impact associated with the updates to the eligibility criteria and payment methodologies.
Public Comment
Interested persons are invited to submit written comments regarding these revisions to the eligibility criteria and payment methodologies to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, P.O. Box 2675, Harrisburg, PA 17120, RA-PWMAProgComments@pa.gov. Comments received within 30 days will be reviewed and considered for any subsequent revision of the notice.
Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania Hamilton Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
MEG SNEAD,
Acting SecretaryFiscal Note: 14-NOT-1552. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 22-1879. Filed for public inspection December 2, 2022, 9:00 a.m.]
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