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PA Bulletin, Doc. No. 08-1070

NOTICES

DEPARTMENT OF
PUBLIC WELFARE

Changes to an Additional Class of Disproportionate Share Payments

[38 Pa.B. 2741]
[Saturday, June 7, 2008]

   The purpose of this notice is to announce the Department of Public Welfare's (Department) intent to revise the criteria and to increase the allocation for disproportionate share hospital (DSH) payments to certain qualifying Medical Assistance (MA) enrolled hospitals. Effective for Fiscal Year (FY) 2007-2008 only, the State General funds allocated for this payment will be increased from $5.862 million to $11.348 million.

   Effective October 1, 2000, the Department established an additional class of DSH payments to certain qualifying hospitals, which the Department determined advanced the Department's goal of enhanced access to multiple types of medical care in economically distressed areas of this Commonwealth. Increases in MA eligibility and service costs require changes to the original qualifying criteria and a one-time payment increase to the amount allocated to guarantee access to care for MA recipients throughout this Commonwealth.

   The Department intends to consider a hospital eligible, provided it is an acute care general hospital that meets all of the following criteria:

   (a)  The hospital provides in excess of 100,000 inpatient days to MA eligible individuals as reported on its FY 2004-2005 MA Hospital Cost Report (MA 336).

   (b)  The hospital has a Low-Income Utilization Rate in excess of the 95th percentile of the Low-Income Utilization Rate for all enrolled acute care general hospitals as reported on its FY 2004-2005 MA Hospital Cost Report (MA 336).

   (c)  The hospital's ratio of MA revenue to net patient revenue exceeds the 98th percentile for all Commonwealth acute care general hospitals as reported in the Pennsylvania Health Care Cost Containment Council's 2006 Financial Analysis, Volume One.

   (d)  The dollar value of the hospital's uncompensated care equals or exceeds the 94th percentile of the value to uncompensated care for all acute care general hospitals as reported in the Pennsylvania Health Care Cost Containment Council's 2006 Financial Analysis, Volume One.

   (e)  The hospital is located in a Census tract designated by the Bureau of Primary Health Care of the Health Resource and Services Administration as a Medically Underserved Area.

   Payments will continue to be divided proportionally between qualifying hospitals based on the percentages of each qualifying hospital's MA inpatient days to the total MA inpatient days of all qualifying hospitals. In making these payments, the Department will continue to ensure that no acute care general hospital will receive a DSH payment that is in excess of its hospital-specific DSH upper payment limit and the Commonwealth will not exceed its aggregate annual DSH allotment.

Fiscal Impact

   For FY 2007-2008, the fiscal impact as a result of the revision to the criteria and the one-time payment increase in DSH payment allotment is $11.949 million in total funds ($5.486 million in State General Funds and $6.463 million in Federal funds).

Public Comment

   Interested persons are invited to submit written comments regarding this notice to the Department at the following address Department of Public Welfare, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. 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 AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

ESTELLE B. RICHMAN,   
Secretary

   Fiscal Note: 14-NOT-550. (1) General Fund:

MA-InpatientAcute Care Hospitals
(2)Implementing Year    2007-08 is $1,986,000$3,500,000
(3)1st Succeeding Year    2008-09 is $0 $0
2nd Succeeding Year    2009-10 is $0 $0
3rd Succeeding Year    2010-11 is $0$0
4th Succeeding Year    2011-12 is $0$0
5th Succeeding Year    2012-13 is $0$0
(4)2006-07 Program-- $513,020,000$14,500,000
2005-06 Program--$474,693,000$10,800,000
2004-05 Program-- $531,785,000 $12,200,000
(7) Medical Assistance (MA) Inpatient and Acute Care Hospitals; (8) recommends adoption. Funds are included in the budget to cover these increased.
[Pa.B. Doc. No. 08-1070. Filed for public inspection June 6, 2008, 9:00 a.m.]



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