Payment for Nursing Facility Services Provided by County Nursing Facilities; County Nursing Facility Supplementation Payment for Fiscal Year 2015-2016
[46 Pa.B. 3356]
[Saturday, June 25, 2016]
This announcement provides advance notice that the Department of Human Services (Department) intends to continue to make an additional payment to certain county nursing facilities in Fiscal Year (FY) 2015-2016.
The act of July 18, 2013 (P.L. 574, No. 71), among other things, directed the Department to distribute $2 million in additional funds from the funds appropriated for Medical Assistance—Long-Term Care to certain county nursing facilities in FY 2013-2014. The act of July 10, 2014 (P.L. 1053, No. 126) continued the county supplementation payment for FY 2014-2015. The act of April 25, 2016 (P.L. 168, No. 25) (Act 25) directs the Department to continue to make an additional payment to qualified county nursing facilities for FY 2015-2016.
The Department will make a county nursing facility supplementation payment to each qualified county nursing facility. As directed by Act 25, a county nursing facility must have a Medical Assistance (MA) occupancy rate of at least 85% and be located in a home rule county that was formerly a county of the second class A to qualify for this supplementation payment. The MA occupancy rate will be determined using the latest acceptable annual cost report as of September 30, 2015, in accordance with 55 Pa. Code § 1189.71(b) (relating to cost reporting).
The Department will calculate each qualified county nursing facility's supplementation payment for FY 2015-2016 by dividing total funds by the number of qualified county 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.
This change will result in a cost of $4.168 million ($2 million in State funds) for FY 2015-2016.
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-1044. (1) General Fund; (2) Implementing Year 2015-16 is $2,000,000; (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. 16-1093. Filed for public inspection June 24, 2016, 9:00 a.m.]
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