NOTICES
DEPARTMENT OF
HUMAN SERVICES
Disproportionate Share Payments and Supplemental Payments to Qualifying Hospitals
[54 Pa.B. 7293]
[Saturday, November 2, 2024]The Department of Human Services (Department) is announcing its intent to allocate funds in Fiscal Year (FY) 2024-2025 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 $16.281 million in total funds for DSH payments to qualifying acute care general hospitals that provide enhanced access to multiple types of medical care in economically distressed areas of this Commonwealth, upon approval by Centers for Medicare & Medicaid Services (CMS).
The Department intends to allocate $1.336 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 $19.276 million in total funds for DSH payments to MA enrolled acute general hospitals that qualify as a trauma center for the purpose of improving access to readily available and coordinated trauma care, upon approval by CMS.
The Department intends to allocate $11.135 million in total funds for DSH payments to qualifying acute care hospitals to promote access to comprehensive inpatient services for MA eligible persons by assuring 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 $9.882 million in total funds for DSH payments to qualifying acute care general hospital burn centers, upon approval by CMS.
The Department intends to allocate $30.465 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 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 $21.250 million in total funds for DSH payments to critical access and qualifying rural hospitals, upon approval by CMS.
The Department intends to allocate $0.902 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 $15.562 million in total funds for DSH payments to qualifying acute care general hospitals that serve the indigent population of cities with a per capita income significantly below the Statewide average for this Commonwealth, upon approval by CMS.
The Department intends to allocate $0.776 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 $5.678 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 $25.230 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 $7.793 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 $10.020 million in total funds for DSH payments to qualifying acute care general hospitals that provide a high volume of services to the MA population to promote continued access to inpatient and ancillary outpatient services in this Commonwealth and to support academic medical programs for integrated patient-centered medical services, upon approval by CMS.
The Department intends to allocate $6.235 million in total funds for DSH payments to qualifying acute care general hospitals to promote the availability of professional medical services to MA populations in less urbanized areas of this Commonwealth by supporting medical education and academic medical programs, upon approval by CMS.
The Department intends to allocate $9.281 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 $108.777 million in total funds for supplemental payments to qualifying acute care general hospitals that treat a high volume of opioid use disorder patients in their emergency rooms, upon approval by CMS.
The Department intends to allocate $59.030 million in total funds for supplemental payments to qualifying acute care general hospitals that treat a high percentage of MA patients under 18 years of age, upon approval by CMS.
The Department intends to allocate $4.998 million in total funds for supplemental payments to qualifying acute care general hospitals located in a county with an estimated general population count of less than 1 million that serve a high percent of MA patients, upon approval by CMS.
The Department intends to allocate $1.800 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 2024-2025 impact, as a result of the funding allocation for these payments, is $366.207 million in total funds (State and Federal), upon approval by CMS.
Public Comment
Interested persons are invited to submit written comments regarding these DSH and supplemental payments 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. 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).
VALERIE A. ARKOOSH,
SecretaryFiscal Note: 14-NOT-1662. Under section 612 of The Administrative Code of 1929 (71 P.S. § 232), (1) General Fund;
(7) MA—Fee for Service; (2) Implementing Year 2024-25 is $68,566,000; (3) 1st Succeeding Year 2025-26 through 5th Succeeding Year 2029-30 are $0; (4) 2023-24 Program—$697,354,000; 2022-23 Program—$589,137,000; 2021-22 Program—$644,059,000;
(7) MA—Academic Medical Centers; (2) Implementing Year 2024-25 is $24,681,000; (3) 1st Succeeding Year 2025-26 through 5th Succeeding Year 2029-30 are $0; (4) 2023-24 Program—$24,682,000; 2022-23 Program—$22,111,000; 2021-22 Program—$21,448,000;
(7) MA—Physician Practice Plans; (2) Implementing Year 2024-25 is $4,000,000; (3) 1st Succeeding Year 2025-26 through 5th Succeeding Year 2029-30 are $0; (4) 2023-24 Program—$10,071,000; 2022-23 Program—$9,706,000; 2021-22 Program—$9,613,000;
(7) Autism Intervention; (2) Implementing Year 2024-25 is $600,000; (3) 1st Succeeding Year 2025-26 through 5th Succeeding Year 2029-30 are $0; (4) 2023-24 Program—$31,679,000; 2022-23 Program—$27,610,000; 2021-22 Program—$27,493,000;
(7) MA—Hospital Based Burn Centers; (2) Implementing Year 2024-25 is $4,438,000; (3) 1st Succeeding Year 2025-26 through 5th Succeeding Year 2029-30 are $0; (4) 2023-24 Program—$4,438,000; 2022-23 Program—$3,975,000; 2021-22 Program—$3,856,000;
(7) MA—Obstetric and Neonatal Services; (2) Implementing Year 2024-25 is $10,682,000; (3) 1st Succeeding Year 2025-26 through 5th Succeeding Year 2029-30 are $0; (4) 2023-24 Program—$3,682,000; 2022-23 Program—$2,986,000; 2021-22 Program—$2,806,000;
(7) MA—Critical Access Hospitals; (2) Implementing Year 2024-25 is $7,943,000; (3) 1st Succeeding Year 2025-26 through 5th Succeeding Year 2029-30 are $0; (4) 2023-24 Program—$14,472,000; 2022-23 Program—$11,364,000; 2021-22 Program—$10,927,000;
(7) MA—Trauma Centers; (2) Implementing Year 2024-25 is $8,657,000; (3) 1st Succeeding Year 2025-26 through 5th Succeeding Year 2029-30 are $0; (4) 2023-24 Program—$8,657,000; 2022-23 Program—$7,755,000; 2021-22 Program—$7,522,000;
(8) recommends adoption. Funds have been included in the budget to cover this increase.
[Pa.B. Doc. No. 24-1584. Filed for public inspection November 1, 2024, 9:00 a.m.]
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