NOTICES
DEPARTMENT OF
HUMAN SERVICES
Supplemental Payments to Qualifying Hospitals
[51 Pa.B. 3929]
[Saturday, July 17, 2021]The Department of Human Services (Department) is announcing its intent to discontinue the Medical Assistance (MA) stability payments beginning with Fiscal Year (FY) 2021-2022. In addition, the Department intends to revise the payment reconciliation process to account for the discontinuation of these payments.
Background
The Department imposes a monetary assessment on the net inpatient revenue and net outpatient revenue of licensed hospitals in this Commonwealth, other than exempt hospitals under Article VIII-G of the Human Services Code (code) (62 P.S. §§ 801-G—816-G). The funds generated by the hospital assessment are used to make MA payments to hospitals and managed care organizations for inpatient and outpatient services, described in section 805-G(a)(1) and (2) of the code (62 P.S. § 805-G(a)(1) and (2)), as well as other purposes as approved by the Secretary for inpatient hospital, outpatient hospital and hospital-related services. The Department has used a portion of these funds for fee-for-service (FFS) MA Stability Payments annually beginning in FY 2010-2011 and continuing through FY 2020-2021. This payment is in the approved State Plan.
Discontinuation of MA Stability Payments
Previously, the Commonwealth's budget included appropriated funds for the MA Stability payments. The Commonwealth's budget for FY 2021-2022 does not include appropriated funding for the MA Stability payments. For this reason, the Department intends to submit a State Plan Amendment to provide for the discontinuation of MA Stability Payments for all hospitals, including what is referred to in the State Plan as new hospitals (new hospitals), beginning with FY 2021-2022. The Department is not otherwise changing its approved State Plan provisions addressing the qualifying criteria or payment methodology for other payments to new hospitals.
Payment Reconciliation
The Department also intends to amend the State Plan to modify the payment reconciliation process used to determine the available funding for certain MA payments funded with assessment revenues. Specifically, effective with the reconciliation of payments for FY 2021-2022 and continuing for subsequent years the Department is proposing to:
a) Specify the periods for which the MA Stability Payment is subject to reconciliation; and,
b) Change the amount of available funding for payments to be reconciled to $201.847 million (and of this amount, specify that the portion attributable to the inpatient disproportionate share payments and direct medical education payments is $40.959 million).
The Department is not otherwise changing its approved State Plan provisions addressing the payment reconciliation process.
Fiscal Impact
Effective FY 2021-2022, and subject to approval by the Centers for Medicare & Medicaid Service, the Department will no longer fund $150.335 million in total funds for this supplemental payment. The Department has increased the available funding for outpatient hospital services made available through the Physical Health HealthChoices managed care program by $150.000 million in total funds effective January 1, 2021.
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 comments received within 30 days.
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-1452. (1) General Fund;
(7) MA—FFS; (2) Implementing Year 2020-21 is $0; (3) 1st Succeeding Year 2021-22 through 5th Succeeding Year 2025-26 is -$33,780,000; (4) 2019-20 Program—$334,085,000; 2018-19 Program—$342,544,000; 2017-18 Program—$477,690,000;
(7) MA—Capitation; (2) Implementing Year 2020-21 is $0; (3) 1st Succeeding Year 2021-22 through 5th Succeeding Year 2025-26 is $33,705,000; (4) 2019-20 Program—$2,507,000,000; 2018-19 Program—$3,303,000,000; 2017-18 Program—$3,106,000,000;
(8) recommends adoption. Funds have been included in the budget to cover this increase.
[Pa.B. Doc. No. 21-1134. Filed for public inspection July 16, 2021, 9:00 a.m.]
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