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PA Bulletin, Doc. No. 08-2314



Additional Class of Disproportionate Share Payments

[38 Pa.B. 7023]
[Saturday, December 20, 2008]

   The purpose of this notice is to announce the Department of Public Welfare's (Department) intent to establish a one-time additional class of disproportionate share hospital (DSH) payments for certain qualifying acute care general hospitals that provide a significant level of inpatient services to the Medical Assistance (MA) population in counties with a high concentration of MA eligible persons.

   MA enrolled hospitals qualifying for this payment shall be located within a county defined as having a high MA concentration based on the June 2008, Pennsylvania (PA) MA eligibility statistics. High MA concentration counties are counties exceeding the 98th percentile on the total number of PA MA eligible persons. Hospitals, located within high MA concentration counties, shall meet all of the following criteria to qualify for this payment based on Fiscal Year (FY) 2005-2006 MA cost report information:

   *  Provide at least 15,000 total acute MA inpatient days.

   *  Rank in at least the 75th percentile on the total number of acute MA inpatient days for all hospitals within the county.

   *  Have a ratio of acute MA inpatient days to total hospital acute inpatient days in excess of the 80th percentile for all hospitals within the county.

   *  Have at least 100,000 total hospital acute inpatient days.

   In addition, hospitals shall have an operating margin lower than 3% for FY 2007 as reported in Pennsylvania Health Care Cost Containment Council's Financial Analysis 2007, Volume One.

   Payments will be divided proportionately among qualifying hospitals based on the percentage of each qualifying hospital's acute MA inpatient days to total hospital bed days used for all qualifying facilities based on FY 2005-2006 MA cost reports.

   In making these one-time payments, the Department will 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

   The FY 2008-2009, fiscal impact as a result of this one-time payment is $10,993,843 in total funds ($5 million in State General funds and $5.994 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 Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).


   Fiscal Note:  14-NOT-576. (1) General Fund; (2) Implementing Year 2008-09 is $5M; (3) 1st Succeeding Year 2009-10 is $0; 2nd Succeeding Year 2010-11 is $0; 3rd Succeeding Year 2011-12 is $0; 4th Succeeding Year 2012-13 is $0; 5th Succeeding Year 2013-14 is $0; (4) 2007-08 Program--$21.175M; 2006-07 Program--$14.500M; 2005-06 Program--$10.800M; (7) Acute Care Hospitals; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 08-2314. Filed for public inspection December 19, 2008, 9:00 a.m.]

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