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PA Bulletin, Doc. No. 16-1095


Payment for Nursing Facility Services Provided by Nonpublic Nursing Facilities Located in a County of the Eighth Class; Nonpublic Nursing Facility Supplementation Payment for Fiscal Year 2015-2016

[46 Pa.B. 3357]
[Saturday, June 25, 2016]

 This announcement provides advance notice that the Department of Human Services (Department) intends to make an additional payment to certain nonpublic nursing facilities in a county of the eighth class in Fiscal Year (FY) 2015-2016.


 The act of April 25, 2016 (P.L. 168, No. 25) (Act 25), among other things, directs the Department to distribute $4 million in additional funds from the funds appropriated for Medical Assistance—Long-Term Care to certain nonpublic nursing facilities in FY 2015-2016.

Proposed Payment

 The Department will make a nonpublic nursing facility supplementation payment to each qualified nonpublic nursing facility. As directed by Act 25, a nonpublic nursing facility must be located in a county of the eighth class, have more than 119 beds and a Medicaid acuity of 1.14 as of August 1, 2015. The number of beds will be the number of licensed beds as of August 1, 2015, and the Medicaid acuity will be determined using the Case Mix Index Report for the August 1, 2015, Picture Date in accordance with 55 Pa. Code § 1187.33 (relating to resident data and picture date reporting requirements).

 The Department will calculate each qualified nonpublic nursing facility's supplementation payment for FY 2015-2016 by dividing the total funds for the supplementation payment by the number of qualified nonpublic nursing facilities.

 The Department will submit a State Plan Amendment (SPA) to the Centers for Medicare & Medicaid Services (CMS). If CMS approves the SPA, the total funds will consist of both State and Federal funding. The Department will use its best efforts to process this supplementation payment within 30 days of the date it receives notice from CMS.

Fiscal Impact

 This change will result in a cost of $8.335 million ($4 million in State funds) for FY 2015-2016.

Public Comment

 Interested persons are invited to submit written comments regarding these proposed changes to the Department of Human Services, Office of Long-Term Living, Bureau of Policy and Regulatory Management, Attention: Marilyn Yocum, P.O. Box 8025, Harrisburg, PA 17105-8025. 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-1042. (1) General Fund; (2) Implementing Year 2015-16 is $4,000,000; (3) 1st Succeeding Year 2016-17 through 5th Succeeding Year 2020-21 are $0; (4) 2014-15 Program—$810,545,000; 2013-14 Program—$820,409,000; 2012-13 Program—$770,903,000; (7) Long-Term Care; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 16-1095. Filed for public inspection June 24, 2016, 9:00 a.m.]

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