NOTICES
DEPARTMENT OF
PUBLIC WELFARE
Payment for Nursing Facility Services Provided by County Nursing Facilities; Pay for Performance Incentive Payments to County Nursing Facilities in Fiscal Year 2014-2015
[44 Pa.B. 6027]
[Saturday, September 20, 2014]This announcement provides advance notice that the Department of Public Welfare (Department) intends to continue to make pay for performance incentive payments to qualified county nursing facilities in Fiscal Year (FY) 2014-2015.
Background
For FY 2006-2007 through 2013-2014 the Department provided pay for performance incentive payments to qualified county nursing facilities. The qualifying criteria and formula used to determine those payments is in the Commonwealth's approved State Plan.
The Department intends to continue the pay for performance incentive payments to qualifying county nursing facilities for FY 2014-2015. To qualify for these payments, a county nursing facility must be a county nursing facility at the time of payment and its Medical Assistance (MA) case-mix index (CMI) for the picture date within the pay for performance payment period must be higher than its facility MA CMI for the previous picture date. To determine the payments, the Department will ascertain the total quarterly funds available for the performance incentive payments and divide that amount by the total MA days for all county nursing facilities meeting the qualifying criteria. The MA days used for each county nursing facility will be the paid MA days identified on the most recent PROMISe data file used to determine eligibility for disproportionate share payments.
To authorize the continuation of the payments for FY 2014-2015 the Department will submit a State Plan Amendment (SPA) to the Federal Centers for Medicare and Medicaid Services (CMS).
Contingent upon the approval by the CMS of the SPA, the Department will continue pay for performance incentive payments to qualified county nursing facilities for FY 2014-2015. The first payment for 2014-2015 will not be made prior to the second quarter of FY 2014-2015. The payments will be made quarterly to qualified county nursing facilities according to the criteria and formula in the Commonwealth's approved State Plan.
Fiscal Impact
The payments are estimated to cost the Department $6.271 million ($3.021 million in State funds) in FY 2014-2015.
Public Comment
Interested persons are invited to submit written comments regarding this notice to the Department of Public Welfare, Office of Long-Term Living, Bureau of Policy and Regulatory Management, Attention: Marilyn Yocum, P. O. Box 8025, Harrisburg, PA 17105-8025. 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).
BEVERLY D. MACKERETH,
SecretaryFiscal Note: 14-NOT-902. (1) General Fund; (2) Implementing Year 2014-15 is $3,021,000; (3) 1st Succeeding Year 2015-16 through 5th Succeeding Year 2019-20 are $0; (4) 2013-14 Program—$820,409,000; 2012-13 Program—$770,903,000; 2011-12 Program—$737,356,000; (7) MA—Long-Term Care; (8) recommends adoption. Funds have been included in the budget to cover this increase.
[Pa.B. Doc. No. 14-1969. Filed for public inspection September 19, 2014, 9:00 a.m.]
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