NOTICES
DEPARTMENT OF
HUMAN SERVICES
Disproportionate Share Payments and Supplemental Hospital Payments to Qualifying Hospitals
[51 Pa.B. 7951]
[Saturday, December 18, 2021]The Department of Human Services (Department) is announcing its intent to allocate funds in Fiscal Year (FY) 2021-2022 for several classes of inpatient disproportionate share hospital (DSH) payments and supplemental payments to Medical Assistance (MA) enrolled, qualifying inpatient acute care general hospitals. The Department does not intend to otherwise change the qualifying criteria or payment methodology for these payments. The qualifying criteria and payment methodology for each payment are described in Pennsylvania's Medicaid State Plan.
All 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.
The allocation of the funds for DSH payments described as follows is contingent on the availability of Federal financial participation for these payments.
Allocation of Funds
The Department intends to allocate $1.057 million in total funds for DSH payments to qualifying acute care general hospitals that have a low commercial-payer ratio, a negative trend in their net patient revenue and are located in an area of this Commonwealth with a disproportionate need for MA services to promote continued access to care for the MA population, upon approval by the Centers for Medicare & Medicaid Services (CMS).
The Department intends to allocate $1.585 million in total funds for DSH payments to qualifying acute care general hospitals to promote access to acute care services for MA eligible persons in less urban areas of this Commonwealth, upon approval by CMS.
The Department intends to allocate $18.293 million in total funds for DSH payments to MA enrolled acute care general hospitals that qualify as a trauma center for the purpose of improving access to readily available and coordinated trauma care for the citizens of this Commonwealth, upon approval by CMS.
The Department intends to allocate $111.585 million in total funds for DSH payments to qualifying MA enrolled acute care hospitals that promote access to comprehensive inpatient services for MA eligible persons by providing an adequate supply of health care professionals who have been trained in high volume MA enrolled hospital settings, upon approval by CMS.
The Department intends to allocate $9.377 million in total funds for DSH payments to qualifying acute care general hospital burn centers, upon approval by CMS.
The Department intends to allocate $14.119 million in total funds for DSH payments to qualifying acute care general hospitals providing obstetrical and neonatal services, upon approval by CMS.
The Department intends to allocate $0.500 million in total funds for DSH payments to qualifying teaching hospitals that provide psychiatric services to MA beneficiaries in order to help offset medical education costs of psychiatrists that are incurred by hospitals providing assistance to MA beneficiaries and uninsured persons, upon approval by CMS.
The Department intends to allocate $34.356 million in total funds for DSH payments to critical access and qualifying rural hospitals, upon approval by CMS.
The Department intends to allocate $ 0.695 million in total funds for DSH payments to qualifying acute care general hospitals that, in partnership with an independent facility listed as a Cleft and Craniofacial Team by the American Cleft Palate-Craniofacial Association, provide surgical services to patients with cleft palate and craniofacial abnormalities, upon approval by CMS.
The Department intends to allocate $0.737 million in total funds funding for DSH payments made to qualifying MA enrolled acute care general hospitals that provide a high volume of inpatient services to MA eligible and low-income populations, upon approval by CMS.
The Department intends to allocate $4.333 million in total funds for DSH payments to qualifying acute care general hospitals that qualify as academic medical centers, upon approval by CMS.
The Department intends to allocate $23.946 million in total funds for DSH payments to qualifying acute care general hospitals to provide additional support for the operation of academic medical programs through the medical education of health care professionals needed to treat the MA population, upon approval by CMS.
The Department intends to allocate $7.397 million in total funds DSH payments to qualifying acute care general hospitals that participate in an academic medical program, upon approval by CMS.
The Department intends to allocate $5.290 million in total funds for supplemental payments to qualifying acute care general hospitals that provide medical and surgical ocular services to MA beneficiaries to ensure continued access to these critical eye related services, upon approval by CMS.
The Department intends to allocate $0.900 million in total funds for supplemental payments to qualifying acute care general hospitals that provide a substantial portion of their inpatient services to MA beneficiaries, upon approval by CMS.
Fiscal Impact
The FY 2021-2022 impact, as a result of the funding allocation for these payments, is $234.170 million in total funds (State and Federal), upon approval by CMS.
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 in determining the final payment methodology for these payments.
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-1471. (1) General Fund;
(7) MA—Fee-for-Service; (2) Implementing Year 2021-22 is $53,460,000; (3) 1st Succeeding Year 2022-23 through 5th Succeeding Year 2026-27 are $0; (4) 2020-21 Program—$808,350,000; 2019-20 Program—$344,107,000; 2018-19 Program—$342,544,000;
(7) MA—Critical Access Hospitals; (2) Implementing Year 2021-22 is $13,057,000; (3) 1st Succeeding Year 2022-23 through 5th Succeeding Year 2026-27 are $0; (4) 2020-21 Program—$9,777,000; 2019-20 Program—$8,850,000; 2018-19 Program—$10,400,000;
(7) MA—Hospital-Based Burn Centers; (2) Implementing Year 2021-22 is $4,437,000; (3) 1st Succeeding Year 2022-23 through 5th Succeeding Year 2026-27 are $0; (4) 2020-21 Program—$3,862,000; 2019-20 Program—$3,792,000; 2018-19 Program—$3,782,000;
(7) MA—Obstetric and Neonatal Services; (2) Implementing Year 2021-22 is $3,681,000; (3) 1st Succeeding Year 2022-23 through 5th Succeeding Year 2026-27 are $0; (4) 2020-21 Program—$2,814,000; 2019-20 Program—$2,709,000; 2018-19 Program—$3,681,000;
(7) MA—Academic Medical Centers; (2) Implementing Year 2021-22 is $17,831,000; (3) 1st Succeeding Year 2022-23 through 5th Succeeding Year 2026-27 are $0; (4) 2020-21 Program—$21,479,000; 2019-20 Program—$21,092,000; 2018-19 Program—$24,681,000;
(7) MA—Physician Practice Plans; (2) Implementing Year 2021-22 is $2,000,000; (3) 1st Succeeding Year 2022-23 through 5th Succeeding Year 2026-27 are $0; (4) 2020-21 Program—$9,618,000; 2019-20 Program—$7,502,000; 2018-19 Program—$10,071,000;
(7) Autism Intervention; (2) Implementing Year 2021-22 is $450,000; (3) 1st Succeeding Year 2022-23 through 5th Succeeding Year 2026-27 are $0; (4) 2020-21 Program—$27,262,000; 2019-20 Program—$27,052,000; 2018-19 Program—$30,842,000;
(7) MA—Trauma Centers; (2) Implementing Year 2021-22 is $8,656,000; (3) 1st Succeeding Year 2022-23 through 5th Succeeding Year 2026-27 are $0; (4) 2020-21 Program—$7,534,000; 2019-20 Program—$7,397,000; 2018-19 Program—$8,656,000;
(8) recommends adoption. Funds have been included in the budget to cover this increase.
[Pa.B. Doc. No. 21-2119. Filed for public inspection December 17, 2021, 9:00 a.m.]
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