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PA Bulletin, Doc. No. 23-605



Change to Disproportionate Share Payments to Qualifying Hospitals

[53 Pa.B. 2489]
[Saturday, May 6, 2023]

 The Department of Human Services (Department) is announcing its intent to increase the funding and amend the payment methodology for a class of disproportionate share hospital (DSH) payments for qualifying acute care general hospitals for Fiscal Year (FY) 2022-2023. These payments will continue to provide financial relief to hospitals and promote access to acute care services for Pennsylvania Medical Assistance (MA) beneficiaries during the novel coronavirus (COVID-19) pandemic. The Department does not intend to otherwise change the qualifying criteria for these payments.

 Payment limitations are still 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.

Payment Methodology

 The Department will determine a qualifying hospital's annual payment amount by multiplying the hospital's number of Pennsylvania MA inpatient acute care days, both fee-for-service and managed care, by either:

 • $168.80 for qualifying hospitals with at least 90% MA dependence percent ranking; or

 • $135.05 for qualifying hospitals with at least 75% but less than 90% MA dependence percent ranking; or

 • $101.27 for qualifying hospitals with at least 50% but less than 75% MA dependence percent ranking; or

 • $67.52 for qualifying hospitals with less than 50% MA dependence percent ranking.

Fiscal Impact

 The total FY 2022-2023 impact as a result of the increase in the allocation for these DSH payments is an annualized amount of $170.421 million in total funds (State and Federal), upon approval by the Centers for Medicare & Medicaid Services.

Public Comment

 Interested persons are invited to submit written comments regarding these DSH payments to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, P.O. Box 2675, 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 Hamilton Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

Acting Secretary

Fiscal Note: 14-NOT-1573. Under section 612 of The Administrative Code of 1929 (71 P.S. § 232), (1) General Fund; (2) Implementing Year 2022-23 is $36,802,000; (3) 1st Succeeding Year 2023-24 is $38,600,000; 2nd Succeeding Year 2024-25 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—Fee-for-Services; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 23-605. Filed for public inspection May 5, 2023, 9:00 a.m.]

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