NOTICES
DEPARTMENT OF
HUMAN SERVICES
Disproportionate Share Payments and Supplemental Payments to Qualifying Hospitals
[52 Pa.B. 7979]
[Saturday, December 24, 2022]The Department of Human Services (Department) is announcing its intent to allocate funds in Fiscal Year (FY) 2022-2023 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 the Commonwealth's Medicaid State Plan.
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 $105.910 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 $1.458 million in total funds for DSH payments to qualifying acute care general hospitals that have a low commercial-payer ratio, a negative trend in their net patient revenue and are located in an area of this Commonwealth with a disproportionate need for MA services, upon approval by CMS.
The Department intends to allocate $1.250 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 $112.900 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 $0.500 million in total funds for DSH payments to qualifying teaching hospitals that provide psychiatric services to MA beneficiaries in order 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 $85.586 million in total funds for DSH payments to provide financial relief to hospitals and promote access to acute care services for MA beneficiaries during the novel coronavirus (COVID-19) pandemic, upon approval by CMS.
The Department intends to allocate $0.688 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 $0.726 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 $4.271 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 $23.606 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 $7.292 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 $9.375 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 $5.833 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 $6.251 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 $89.214 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 $4.783 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 $5.208 million in total funds for supplemental payments to qualifying acute care general hospitals that provide a high volume of services to MA eligible and low-income populations in nonrural medically underserved areas, upon approval by CMS.
The Department intends to allocate $0.900 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 2022-2023 impact, as a result of the funding allocation for these payments, is $465.751 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-PWMAProg Comments@pa.gov. 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 Hamilton Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
MEG SNEAD,
Acting SecretaryFiscal Note: 14-NOT-1556. (1) General Fund;
(7) MA—Fee-for-Service; (2) Implementing Year 2022-23 is $153,066,000; (3) 1st Succeeding Year 2023-24 through 5th Succeeding Year 2027-28 are $0; (4) 2021-22 Program—$644,059,000; 2020-21 Program—$808,350,000; 2019-20 Program—$344,107,000;
(7) MA—Academic Medical Centers; (2) Implementing Year 2022-23 is $21,493,000; (3) 1st Succeeding Year 2023-24 through 5th Succeeding Year 2027-28 are $0; (4) 2021-22 Program—$21,448,000; 2020-21 Program—$21,749,000; 2019-20 Program—$21,092,000;
(7) MA—Physician Practice Plans; (2) Implementing Year 2022-23 is $3,047,000; (3) 1st Succeeding Year 2023-24 through 5th Succeeding Year 2027-28 are $0; (4) 2021-22 Program—$9,613,000; 2020-21 Program—$9,618,000; 2019-20 Program—$7,502,000;
(7) MA—Autism Intervention; (2) Implementing Year 2022-23 is $523,000; (3) 1st Succeeding Year 2023-24 through 5th Succeeding Year 2027-28 are $0; (4) 2021-22 Program—$27,493,000; 2020-21 Program—$27,262,000; 2019-20 Program—$27,052,000;
(8) recommends adoption. Funds have been included in the budget to cover this increase.
[Pa.B. Doc. No. 22-1985. Filed for public inspection December 23, 2022, 9:00 a.m.]
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