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PA Bulletin, Doc. No. 09-589

NOTICES

Payments to County Nursing Facilities; Final Rates for State Fiscal Year 2008-2009

[39 Pa.B. 1595]
[Saturday, March 28, 2009]

   The purpose of this notice is to announce the Department of Public Welfare's (Department) final annual rates for State Fiscal Year (FY) 2008-2009, for county nursing facilities that participate in the Medical Assistance (MA) Program.

   The rates are calculated in accordance with 55 Pa. Code Chapter 1189, Subchapter D (relating to rate setting). As stated at 55 Pa. Code § 1189.91(b) (relating to per diem rates for county nursing facilities), for each rate year beginning on or after July 1, 2007, the per diem rate paid to a county nursing facility for a rate year will be the facility's prior rate year per diem rate multiplied by a budget adjustment factor (BAF).

   As required by § 1189.91(d), the Department followed the formula set forth in the Commonwealth's approved State Plan to determine that the BAF for FY 2008-2009 for county nursing facilities is 1.00. The Federal Centers for Medicare and Medicaid Services (CMS) approved State Plan Amendment 08-008 on December 12, 2008.

   SPA 08-008 states that for rate setting year 2008-2009, the BAF shall limit the estimated aggregate increase in the Statewide day-weighted average payment rate for MA nursing facility services for county and nonpublic nursing facilities so that the aggregate percentage rate of increase for the period that begins July 1, 2005, and ends on June 30, 2009, is limited to the amount permitted by the funds appropriated by the General Appropriations Act of 2008 (Act 38A). The formula for this BAF as it applies to county nursing facilities is BAF=1.00+0.01.

   The final FY 2008-2009 annual per diem rates are available on the web site for the Department of Public Welfare at: www.dpw.state.pa.us/PartnersProviders/LongTermLiving/ and at local county assistance offices throughout the Commonwealth or by contacting Gail Weidman, Office of Long-Term Living at (717) 705-3705.

Public Process

   The Department published a notice in the Pennsylvania Bulletin announcing its proposed county per diem payment rates for FY 2008-2009 at 38 Pa.B. 6342 (November 15, 2008) and invited interested persons to submit comments. No comments were received by the Department in response to the proposed rate notice.

Appeals

   Following publication of this notice, the Department will send rate letters to each county MA nursing facility to notify the facilities of their final rates for FY 2008-2009. The rate letter will also advise the facility that it may file an administrative appeal if the facility believes that the Department made any errors or otherwise disagrees with its final rates for FY 2008-2009. A provider's appeal must be in writing and filed with the Department's Bureau of Hearings and Appeals, P. O. Box 2675, Harrisburg, PA 17105, within 33 days of the date of the Department's letter notifying the facility of its final rates. Facilities should refer to 67 Pa.C.S. Chapter 11 (relating to medical assistance hearings and appeals), and to the Department's regulations at 55 Pa. Code Chapter 41 (relating to medical assistance provider appeal procedures), for more detail regarding their appeal rights and the requirements related to their written appeals.

Fiscal Impact

   These changes will result in an estimated cost of $7.775 million ($3.545 million in State funds) for county nursing facilities in 2008-2009 compared to the final April 1, 2008 rates. Funding for these changes has been included in the MA Long-Term Care appropriation.

Public Comment

   Interested persons are invited to submit written comments regarding the final rates for FY 2008-2009 to the Department at the following address: Department of Public Welfare, Office of Long-Term Living, Attention: Gail Weidman, P. O. Box 2675, Harrisburg, PA 17105. 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 AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

ESTELLE B. RICHMAN,   
Secretary

   Fiscal Note: 14-NOT-591. (1) General Fund; (2) Implementing Year 2008-09 is $3.545 M; (3) 1st Succeeding Year 2009-10 is $3.867 M; 2nd Succeeding Year 2010-11 is $3.867 M; 3rd Succeeding Year 2011-12 is $3.867 M; 4th Succeeding Year 2012-13 is $ 3.867 M; 5th Succeeding Year 2013-14 is $3.867 M; (4) 2007-08 Program--$692.585 M; 2006-07 Program--$695.279 M; 2005-06 Program--$817.890 M; (7) Long-Term Care; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 09-589. Filed for public inspection March 27, 2009, 9:00 a.m.]


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