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PA Bulletin, Doc. No. 23-1521

NOTICES

DEPARTMENT OF
HUMAN SERVICES

Statewide Quality Care Assessment Program for Fiscal Years 2023-2024 through 2027-2028

[53 Pa.B. 6939]
[Saturday, November 4, 2023]

 This notice announces the continuation of the Statewide Quality Care Assessment Program (Program) from Fiscal Years (FY) 2023-2024 through FY 2027-2028, as provided for by the act of June 13, 1967 (P.L. 31, No. 21), as amended by Act 15 of 2023 (Act).

Background

 Article VIII-G of the Human Services Code (code)1 (62 P.S. §§ 801-G—816-G) authorizes the Department of Human Services (Department) to implement the Program beginning July 1, 2010. Under the code, the Department imposes a monetary assessment on all licensed hospitals in this Commonwealth other than certain exempt hospitals.2 See 62 P.S. §§ 801-G—816-G.

Discussion

 The Act amended Article VIII-G of the code. The Act extends the Program through June 30, 2028, and authorizes the Secretary of Human Services (Secretary) to establish a new base year for the calculation of net inpatient and net outpatient revenue amounts for the purposes of calculating the annual assessments owed on or after July 1, 2023, and changes the assessment rate.

 The Act set the assessment percentage rate under the Program for FY 2023-2024 as 3.54% of the net inpatient revenue of the covered hospital and 1.78% of the net outpatient revenue of the covered hospital. The Act further specifies that, for FY 2024-2025—2027-2028, the assessment percentage rate under the Program will be 4.36% of the net inpatient revenue of the covered hospital and 2.20% of the net outpatient revenue of the covered hospital. The Secretary may, however, adjust the assessment percentages for all or part of a fiscal year. See 62 P.S. § 803-G.

 The Act provides that for purposes of calculating the amounts owed beginning in FY 2023-2024, the Secretary may require the use of the net inpatient revenue and the net outpatient revenue as identified in the records of a covered hospital for FY 2018-2019. Accordingly, the Department will use the hospitals' net inpatient and net outpatient revenue for State FY 2018-2019 to calculate the amount owed. As specified in the Act, if the Secretary intends to calculate the amounts owed using for the net inpatient and net outpatient revenue amounts as identified in hospitals' records for a year after FY 2018-2019, the Secretary will issue a public notice. Subject to conditions specified in 62 P.S. § 813-G, the Department intends to use the revenue derived from this assessment to make medical assistance payment to hospitals in accordance with 62 P.S. § 805-G.

Fiscal Impact

 The Department estimates that the FY 2023-2024 aggregate assessment fees for nonexempt hospitals to total $1,222.578 million. The Department estimates that the annual aggregate assessment fees for the nonexempt hospitals for FY 2024-2025 through FY 2027-2028 to total $1,506.798 million annually.

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, P.O. Box 2675, Harrisburg, PA 17120, RA-PWMAProgComments@pa.gov. 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 Hamilton Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

VALERIE A. ARKOOSH, 
Secretary

 Fiscal Note: 14-NOT-1596. Under section 612 of The Administrative Code of 1929 (71 P.S. § 232), (1) General Fund;

 (7) Medical Assistance (MA)—Fee-for-Service; (2) Implementing Year 2023-24 is -$136,139,000; (3) 1st Succeeding Year 2024-25 through 4th Succeeding Year 2027-28 is -$137,330,000; 5th Succeeding Year 2028-29 is $0; (4) 2022-23 Program—$589,137,000; 2021-22 Program—$644,059,000; 2020-21 Program—$808,350,000;

 (7) MA—Community HealthChoices; (2) Implementing Year 2023-24 is -$62,757,000; (3) 1st Succeeding Year 2024-25 through 4th Succeeding Year 2027-28 are -$62,774,000; 5th Succeeding Year 2028-29 is $0; (4) 2022-23 Program—$4,460,000,000; 2021-22 Program—$4,252,000,000; 2020-21 Program—$3,166,000,000;

 (7) MA—Capitation; (2) Implementing Year 2023-24 is -$1,017,000,000; (3) 1st Succeeding Year 2024-25 through 4th Succeeding Year 2027-28 are -$1,300,000,000; 5th Succeeding Year 2028-29 is $0; (4) 2022-23 Program—$3,418,000,000; 2021-22 Program—$4,557,000,000; 2020-21 Program—$3,060,000,000;

 (7) MA—Critical Access Hospitals; (2) Implementing Year 2023-24 is -$3,200,000; (3) 1st Succeeding Year 2024-25 through 4th Succeeding Year 2027-28 are -$3,200,000; 5th Succeeding Year 2028-29 is $0; (4) 2022-23 Program—$11,364,000; 2021-22 Program—$10,927,000; 2020-21 Program—$9,777,000;

 (7) MA—Obstetric and Neonatal Services; (2) Implementing Year 2023-24 is -$3,000,000; (3) 1st Succeeding Year 2024-25 through 4th Succeeding Year 2027-28 are -$3,000,000; 5th Succeeding Year 2028-29 is $0; (4) 2022-23 Program—$2,986,000; 2021-22 Program—$2,806,000; 2020-21 Program—$2,814,000;

 (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 23-1521. Filed for public inspection November 3, 2023, 9:00 a.m.]

_______

1  Article VIII-G was added to the Human Services Code by the act of July 9, 2010 (P.L. 336, No. 49), and amended by the act of July 9, 2013 (P.L. 369, No. 55), the act of December 28, 2015 (P.L. 500, No. 92), the act of June 22, 2018 (P.L. 258, No. 40) and the act of October 23, 2023 (P.L. 65, No. 15).

2  The following hospitals are exempt from the assessment: (1) Federal veterans' affairs hospitals; (2) hospitals that provide care, including inpatient hospital services, to all patients free of charge; (3) private psychiatric hospitals; (4) State-owned psychiatric hospitals; (5) critical access hospitals; (6) long-term acute care hospitals; and (7) free-standing acute care hospitals organized primarily for the treatment of and research on cancer in which at least 3017f the inpatient admissions had cancer as the principal diagnosis based on Pennsylvania Health Care Cost Containment Council Calendar Year 2014 inpatient discharge data. For the purposes of meeting the definition of (7), only discharges with ICD-9-CM principal diagnoses codes of 140 through 239, V58.0, V58.1, V66.1, V66.2 or 990 are considered. 62 P.S. § 801-G.


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