NOTICES
DEPARTMENT OF
HUMAN SERVICES
Payments to Nonpublic and County Nursing Facilities; Proposed Rates for State Fiscal Year 2023-2024
[53 Pa.B. 3385]
[Saturday, June 24, 2023]This notice announces the Department of Human Services (Department) proposed annual case-mix per diem payment rates for State Fiscal Year (FY) 2023-2024 for nonpublic and county nursing facilities that participate in the Medical Assistance (MA) Program.
Nonpublic Nursing Facility Per Diem Rates
As required by the case-mix payment methodology in 55 Pa. Code Chapter 1187, Subchapter G (relating to rate setting), the Department intends to set an annual MA per diem rate for each nonpublic nursing facility provider. Each facility's annual per diem rate will have four components: resident care, other resident related, administrative and capital. For each quarter of FY 2023-2024, the Department will adjust the resident care component of each facility's rate by multiplying the resident care component by the facility's MA case-mix index for the appropriate picture date.
Additionally, the Fiscal Code amendments in Act 54 of 2022 (P.L. 540, No. 54) authorize a budget adjustment factor (BAF) until June 30, 2026.
A detailed description of the BAF formula is in the notice, Payment for Nursing Facility Services Provided by County and Nonpublic Nursing Facilities; Notice of Change in Methods and Standards of Setting Payment Rates; Budget Adjustment Factor published at 52 Pa.B. 3637 (June 25, 2022). Under the proposed formula, the BAF will limit the estimated Statewide day-weighted average payment rate for MA nursing facility services for nonpublic nursing facilities so that the average payment rate in effect for the fiscal year is limited to the amount permitted by the funds appropriated by the General Appropriation Act for the fiscal year. A BAF will be calculated each quarter for nonpublic nursing facilities.
Finally, in calculating the proposed rates, the Department assumed that the General Appropriation Act of 2023 will include the same level of funding that was in the General Appropriation Act of 2022.
County Nursing Facility Per Diem Rates
As required by the rate methodology in 55 Pa. Code Chapter 1189, Subchapter D (relating to rate setting), the Department intends to set an annual MA per diem rate for each county nursing facility provider. As specified in 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 multiplied by a BAF determined in accordance with the formula in the Commonwealth's approved State Plan. Again, in calculating the proposed rates, the Department assumes that the General Appropriation Act of 2023 will include the same level of funding that was in the General Appropriation Act of 2022.
The proposed annual per diem rates for FY 2023-2024, the July Quarterly BAF that will be applied to nonpublic nursing facility rates and the annual BAF that will be applied to county nursing facilities are available on the Department's web site at https://www.dhs.pa.gov/providers/Providers/Pages/Rates-Nursing%20Facilites.aspx and at local county assistance offices throughout this Commonwealth or by contacting Erica Justice, Department of Human Services, Office of Long-Term Living, at (717) 857-3280.
Fiscal Impact
If the proposed payment rates are adopted as final, there will be no fiscal impact for per diem rate payments for nonpublic and county nursing facilities for FY 2023-2024. The amount of funding available for this program is dependent upon the funds appropriated by the General Assembly in the forthcoming fiscal year. Therefore, until a budget bill is passed and enacted, any estimated fiscal impact associated with this notice is based on the funding levels in the General Appropriation Act of 2022.
Public Comment
Interested persons are invited to submit written comments regarding the proposed annual rates for FY 2023-2024 to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Erica Justice, P.O. Box 8025, Harrisburg, PA 17105-8025 or at RA-PWOLTLNFPUBLICCOM@pa.gov. Comments received within 30 days will be reviewed and considered.
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).
VALERIE A. ARKOOSH,
Acting SecretaryFiscal Note: 14-NOT-1583. No fiscal impact; recommends adoption.
[Pa.B. Doc. No. 23-826. Filed for public inspection June 23, 2023, 9:00 a.m.]
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