NOTICES
Public Notice of the Department's Intent to Revise Community Access Disproportionate Share Payments
[28 Pa.B. 6350] The purpose of this announcement is to provide prior public notice of changes to the Department of Public Welfare's (Department's) previously established additional class of disproportionate share payments. This announcement provides notice of an additional qualifying method for disproportionate share payments. These changes are effective January 15, 1999.
Under State Plan Amendment (SPA) 97-01 which was subsequently amended by SPA 98-03, the Department established a new class of disproportionate share payments known as Community Access payments, in addition to the classes of payment already provided under the Medical Assistance Program. Community Access payments are made to those hospitals which render uncompensated care and which the Department has determined are experiencing significant revenue loss as a result of Medical Assistance Program revisions under Act No. 1996-35.
The Department intends to consider a hospital eligible for these payments if:
* based on the Department's determination of GA/MNO discontinued eligibility, the hospital's annual net patient revenue loss exceeds $3.2 million and the hospital received less than $1.8 million in annual direct medical education payments in Fiscal Year 1996-97; or
* based on the Department's determination of GA/MNO discontinued eligibility, the hospital's annual net patient revenue loss exceeds $3.2 million, the hospital received annual direct medical education payments of over $1.8 million in Fiscal Year 1996-97 and the hospital's loss of total annual Medical Assistance revenue is less than 15%; or
* based on the Department's determination of GA/MNO discontinued eligibility, the hospital's annual net patient revenue loss exceeds $2.5 million with a percentage loss of net patient revenue exceeding 6%; or
* the hospital was eligible for disproportionate share as a rural hospital as defined under the Department's disproportionate share payment policy in calendar year 1997.
The Department will allocate $11 million from the State General Fund for this component of Community Access. The payments will be made to qualifying hospitals based on their percentage of discontinued revenue to the total discontinued revenue of all qualifying hospitals. All payment limitations are still applicable, namely, the Commonwealth may not exceed its aggregate annual disproportionate share allotment, and no hospital may receive disproportionate share payments in excess of its hospital-specific limit.
Charity Care Component
In addition to the above qualifying method, the Department will consider a hospital eligible to receive payment under the Charity Care component of Community Access if:
* the hospital is enrolled in the Medical Assistance Program as an acute care general hospital; and
* the hospital's inpatient charity care cost exceeds $698,501, the Fiscal Year 1995-96 Statewide average inpatient charity care cost. The charity care cost is derived from the Fiscal Year 1995-96 Financial Report for Hospital and Hospital-Health Care Complex Under the Medical Assistance Program (MA 336), as submitted by the hospitals and reviewed by the Department.
The Department will allocate $6.5 million from the State General Fund for the Charity Care component. Payment will be made to qualifying hospitals based on each hospital's percentage of charity care cost to the total charity care costs of all qualifying hospitals. Payment is determined by multiplying the hospital-specific percentage by the total funds available under the charity care component, with a maximum payment per hospital of $750,000. These payments will not cause the Commonwealth to exceed its aggregate annual disproportionate share allotment and again, no hospital may receive disproportionate share payments in excess of its hospital-specific limit.
Fiscal Impact
For Fiscal Year 1998-99, the fiscal impact as a result of the Community Access Fund will be $37.8 million in total funds ($17.5 million in State General funds and $20.3 million in Federal funds).
Contact Person
A copy of this notice is available for review at local County Assistance Offices. Interested persons are invited to submit written comments to this notice within 15 days of this publication. These comments should be sent to the Department of Public Welfare, Office of Medical Assistance Programs, c/o Deputy Secretary's Office, Attention: Regulations Coordinator, Room 515 Health and Welfare Building, Harrisburg, PA 17120.
Persons with a disability may use the AT&T Relay Service by calling (800) 654-5984 (TDD Users) or (800) 654-5988 (Voice Users). Persons who require an alternate format should contact Thomas Vracarich at (717) 783-2209.
FEATHER O. HOUSTOUN,
SecretaryFiscal Note: 14-NOT-187. (1) General Fund; (2) Implementing Year 1998-99 is $17.5 million; (3) 1st Succeeding Year 1999-00 is $0 million; 2nd Succeeding Year 2000-01 is $0 million; 3rd Succeeding Year 2001-02 is $0 million; 4th Succeeding Year 2002-03 is $0 million; 5th Succeeding Year 2003-04 is $0 million; (4) FY 1997-98 $428 million; FY 1996-97 $436 million; FY 1995-96 $452 million; (7) Medical Assistance-Inpatient; (8) recommends adoption. Funds are included in the 1998-99 budget for this purpose.
[Pa.B. Doc. No. 98-2126. Filed for public inspection December 24, 1998, 9:00 a.m.]
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