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PA Bulletin, Doc. No. 96-1842

NOTICES

Office of Medical Assistance Programs; Intergovernmental Transfer of Funds--Nursing Facility Payments

[26 Pa.B. 5261]

   The purpose of this announcement is to provide advance notice under 42 CFR 447.205 that, during FY 1996-1997, the Department of Public Welfare intends to make changes in its payments to nursing facilities participating in the Medical Assistance Program.

   The Department intends to enter into an agreement with the County Commissioners Association of Pennsylvania which will authorize the transfer of funds to the Commonwealth from several counties (as authorized under Federal law [42 U.S.C.A. § 1396b(w)(6)(A) and 42 CFR 433.51(b)]). The funds from this intergovernmental transfer will be used as the State share for a portion of the payments for nursing facility Medical Assistance services during FY 1996-1997.

   Under Federal law, the Department is permitted to pay for nursing facility services at rates which, in the aggregate, do not exceed the amount that would be paid for these services under Medicare cost principles. The Department has determined that to the extent it can utilize funds that have been transferred to the Commonwealth by local county governments to contribute towards the payment of nursing facility services at rates which are below the Medicare upper limit, yet higher than the rates that the Department might otherwise pay for these services, the Department will do so.

   If the intergovernmental transfer agreement is executed and funds are transferred to the Commonwealth for FY 1996-1997, the Department intends to make supplementation payments to large county nursing facilities with a high volume of Medicaid funded resident days. In addition, the Department intends to revise its method for setting payment rates for general nursing facilities (excluding county nursing facilities) participating in the Medical Assistance Program during FY 1996-1997 to allow for enhanced transition payments under the case-mix payment system.

   These proposed changes in nursing facility payments during FY 1996-1997 are contingent upon:  (1) approval by the Federal government of amendments to Pennsylvania's State Plan authorizing the county supplementation payments and the enhanced transition payments; and (2) the Commonwealth's receipt of intergovernmental transfers of funds from county governments in amounts sufficient to make the increased payments.

   The estimated increase in annual aggregate expenditures during FY 1996-1997 is $726,880 million in total funds ($373,471 million in intergovernmental transfer funds). The Department will publish revisions to 55 Pa. Code Chapter 1187 to implement the changes with respect to the enhanced transition payments if the intergovernmental transfer of funds is successfully implemented.

   A copy of this notice is available for review at the local County Assistance Offices throughout the Commonwealth. Interested persons are invited to submit written comments about this notice to the Department within 30 days of publication of this notice in the Pennsylvania Bulletin. Comments should be addressed to:  Department of Public Welfare, Office of Medical Assistance, Bureau of Long Term Care Programs, Division of Long Term Care Provider Services, P. O. Box 8025, Harrisburg, PA 17105.

   Persons with a disability may use the AT&T Relay Services by calling 1 (800) 654-5984 (TDD Users) or 1 (800) 654-5988 (Voice Users), or may use the Department of Public Welfare TDD by calling (717) 787-3616. Persons who require another alternative should contact Thomas Vracarich at (717) 783-2209.

FEATHER O. HOUSTOUN,   
Secretary

   Fiscal Note: 14-NOT-134. (1) General Fund; (2) Implementing Year 1996-97 is $373,471,000; (3) 1st Succeeding Year 1997-98 is $; 2nd Succeeding Year 1998-99 is $; 3rd Succeeding Year 1999-00 is $; 4th Succeeding Year 2000-01 is $; 5th Succeeding Year 2001-02 is $; (4) Fiscal Year 1995-96 is $648,353,000; Fiscal Year 1994-95 is $593,753,000; Fiscal Year 1993-94 is $493,275,000; (7) Medical Assistance-Long Term Care; (8) recommends adoption. The additional costs outlined above will be provided from intergovernmental transfer fund payments.

[Pa.B. Doc. No. 96-1842. Filed for public inspection November 1, 1996, 9:00 a.m.]



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