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PA Bulletin, Doc. No. 10-334


Surcharge for The Patient Safety Trust Fund Under the Medical Care Accountability and Reduction of Error Act

[40 Pa.B. 1048]
[Saturday, February 20, 2010]

 On March 20, 2002, the Medical Care Accountability and Reduction of Error (MCARE) Act (40 P. S. §§ 1303.101—1303.910). Among other provisions, the MCARE Act established the Patient Safety Authority (Authority) to collect, analyze and evaluate data regarding reports of serious events and incidents occurring in certain medical facilities and to make recommendations to those facilities regarding changes, trends and improvements in health care practices and procedures for the purpose of reducing the number and severity of serious events and incidents.

 Section 305(a) of the MCARE Act (40 P. S. § 1303.305(a)) authorizes the establishment of a Patient Safety Trust Fund (Fund) for the operations of the Authority. Section 305(c) of the MCARE Act states that commencing July 1, 2002, and for every fiscal year (FY) thereafter, each medical facility covered by the MCARE Act shall pay the Department of Health (Department) a surcharge on its licensing fee as necessary to provide sufficient revenues for the Authority to operate. Section 305(c) also states that the total assessment amount for FY 2002-2003 shall not exceed $5,000,000 and that the Department shall transfer the total assessment amount to the Fund within 30 days of receipt. Section 305(d) provides that for each succeeding calendar year, the Department shall determine and assess each medical facility a proportionate share of the Authority's budget. The base amount of $5,000,000 provided for in FY 2002-2003 shall be increased no more than the Consumer Price Index in each succeeding FY.

 With the cooperation of this Commonwealth hospitals, birthing centers, abortion centers and ambulatory surgery facilities, the surcharge has been implemented, and has provided resources for the implementation of the web-based Pennsylvania Patient Safety Reporting System and the operation of the Authority.

 • The FY 2007-2008 surcharge assessment was approximately $5,400,000. In FY 2008-2009, due to the economic downturn, the Authority utilized reserves in the Fund to supplement some of the surcharge assessment. The FY 2008-2009 surcharge assessment was approximately $4,000,000 and was paid by facilities in the summer of 2009. The Authority has recommended that the FY 2009-2010 surcharge assessment total $5,000,000. This amount is approximately 7% less than FY 2007-2008 and 20% less than the total annual amount that could be assessed for the year. The Authority Board took several points into account in developing its recommendation including:

 • The Fund will have a negative uncommitted balance by the end of the current FY in June 2010.

 • The Authority budget only increased by 2% for this FY. All additional budgeted spending is focused on programs assisting facilities with patient safety programs. Staff did not receive pay increases for this FY. The Authority FY 2009-2010 budget is approximately $5,800,000. Staff anticipates expenditures for this time period will be approximately $5,500,000 resulting in savings of approximately $300,000.

 This notice sets forth the procedure that the Department will follow in assessing and collecting the surcharge for FY 2009-2010. The MCARE Act states that the surcharge shall be collected from medical facilities, which are defined as ambulatory surgical facilities (ASFs), birth centers, hospitals and abortion clinics licensed under either the Health Care Facilities Act (35 P. S. §§ 448.101—448.904) or the Public Welfare Code Article X (62 P. S. §§ 1001—1087). Nursing Homes, which are assessed under Chapter 4, receive a separate assessment notification.

 To assess the surcharge in an equitable manner, the Department continues to use a common denominator in these facilities. For ASFs, birth centers and abortion clinics, the Department has chosen the number of operating and procedure rooms; and for hospitals, the Department has chosen the number of beds contained on the license of each hospital, whether by the Department (general and special acute care hospitals) or the Department of Public Welfare (privately owned psychiatric hospitals). It was also necessary to pick a point in time to make this assessment; the Department has chosen January 15, 2010.

 The number of operating/procedure rooms (for ASFs, birth centers and abortion clinics) and the number of licensed beds (for hospitals) was totaled and that number was divided into $5,000,000 to arrive at a charge per unit for the assessment. The total number of units (operating rooms, procedure rooms and licensed beds) is 43,182. Dividing this number into $5,000,000 results in a per unit assessment for each installment of approximately $115.78.

 To obtain a copy of the assessment for all facilities, send an e-mail to, and request the 2009-2010 MCARE surcharge assessment list.

 Each facility will receive notification from the Department setting forth the amount due, date due and the name and address to which the payment should be sent. Payment will be due within 60 days. The MCARE Act authorized the Department to assess an administrative penalty of $1,000 per day on facilities who fail to pay the surcharge by the due date.

 If a medical facility has any questions concerning this notice, a representative from that facility should contact Joanne Salsgiver, Director, Department of Health, Division of Acute and Ambulatory Care, 625 Forster Street, Health and Welfare Building, Room 532, Harrisburg, PA 17120, (717) 783-8980.

 Persons with a disability who require an alternative format of this document (for example, large print, audiotape or Braille) should contact the Division of Acute and Ambulatory Care at the previously listed address or telephone number, or V/VT (717) 783-6514 for speech and/or hearing impaired persons, or the Pennsylvania AT&T Relay Service at (800) 654-5984.


[Pa.B. Doc. No. 10-334. Filed for public inspection February 19, 2010, 9:00 a.m.]

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