NOTICES
Payment for Nursing Facility Services; Nursing Facility Supplementation Payment
[33 Pa.B. 3083] The purpose of this announcement is to provide advance notice that the Department of Public Welfare (Department) intends to make changes in its methods and standards for payment of Medical Assistance (MA) nursing facility services beginning in fiscal year (FY) 2003-2004.
The Commonwealth budget for MA long-term care services for FY 2003-2004 assumes that $320 million will be derived from State revenue collected from an assessment on nursing facilities and related Federal matching funds. Legislation must be enacted to impose the assessment and collect the anticipated State revenues. If assessment legislation is enacted, the revenue generated from the assessment will enable the Department to continue to set payment rates for MA nursing facility services under the existing case-mix payment methodology and to make supplementation payments to private MA nursing facility providers. Taking into account the additional supplementation payments, the Department projects that the assessment revenues and associated Federal matching funds will increase overall payments to MA nursing facility providers in FY 2003-2004.
To authorize the additional supplementation payments, the Department will submit a State Plan Amendment to the Federal Centers for Medicare and Medicaid Services (CMS) that proposes changes in the methods and standards for setting nursing facility payment rates. If CMS approves the State Plan amendment, the Department will make the supplementation payments to MA nursing facilities, other than county nursing facilities, in periodic lump sum payments. The supplementation payments will be calculated on a per diem basis that varies depending on the MA occupancy of the facilities. The supplementation payments will enable the facilities to increase salaries to direct care staff to maintain or increase staffing levels at a time when it is difficult to attract and keep qualified staff. Regardless of whether an MA resident currently occupies a Medicaid-certified bed, the Department recognizes the facility's need to staff and maintain the bed in readiness for an MA resident. The supplementation payments also will provide the facilities with additional funds to meet other unanticipated costs that may not be reflected in the current database used to establish rates, such as increased liability insurance costs and the assessment costs. Finally, the supplementation payments will help to offset decreased revenues that may have resulted from declines in the facilities' investment income.
Fiscal Impact
As a result of this proposed policy change, the Department estimates that annual aggregate expenditures for MA nursing facility services for FY 2003-2004 will increase by $275.646 million ($116.571 million in State funds).
Public Comment
Interested persons are invited to submit written comments about the changes to the case-mix payment system to the Department within 30 days of publication of this notice in the Pennsylvania Bulletin. Comments should be addressed to the Department of Public Welfare, Division of Long Term Care Client Services, Attention Gail Weidman, P. O. Box 2675, Harrisburg, PA 17105.
Persons with a disability may use the AT&T Relay Service by calling (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
ESTELLE B. RICHMAN,
SecretaryFiscal Note: 14-NOT-368. (1) General Fund; (2) Implementing Year 2003-04 is $116,571,000; (3) 1st Succeeding Year 2004-05 is $116,571,000; 2nd Succeeding Year 2005-06 is $116,571,000; 3rd Succeeding Year 2006-07 is $116,571,000; 4th Succeeding Year 2007-08 is $116,571,000; 5th Succeeding Year 2008-09 is $116,571,000; (4) 2001-02 Program--$761,877,000; 2000-01 Program--$722,565,000; 1999-00--$693,625,000; (7) Medical Assistance--Long Term Care; (8) recommends adoption. Funding for this change will be derived from revenue collected from an assessment on nursing home facilities authorized by recently enacted State legislation.
[Pa.B. Doc. No. 03-1271. Filed for public inspection June 27, 2003, 9:00 a.m.]
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