Statewide Quality Care Assessment Program for Fiscal Years 2018-2019 through 2022-2023
[48 Pa.B. 7266]
[Saturday, November 17, 2018]
This notice describes the continuation of the Statewide Quality Care Assessment Program (Program) from Fiscal Year (FY) 2018-2019 through 2022-2023, as provided for by the act of June 22, 2018 (P.L. 258, No. 40) (Act).
Article VIII-G of the Human Services Code (law)1 authorizes the Department of Human Services (Department) to implement the Program beginning July 1, 2010. Under the law, the Department imposes a monetary assessment on all licensed hospitals in this Commonwealth other than certain exempt hospitals.2 See 62 P.S. §§ 801-G—816-G.
The Act amended Article VIII-G of the law. The Act extended the Program through FY 2022-2023, added ''net outpatient revenue'' as a factor in calculating the assessments, allows the Secretary of Human Services to establish a new base level for net inpatient and net outpatient revenue amounts for the purposes of calculating the annual assessments owed on or after July 1, 2018, requires the Department to prepare a revenue reconciliation report on the restricted account that contains the assessment revenues and provides that any positive balance remaining in the restricted account in excess of $10 million annually, which is not used by the Commonwealth to obtain Federal matching funds and paid out for hospital payments, shall be factored into the calculation of a new assessment rate by reducing the amount of hospital assessment funds that must be generated during the next fiscal year in which the Department is able to calculate a new rate, or the funds remaining in the restricted account shall be refunded to the covered hospital that paid the assessment in proportion to the covered hospital's assessment amount paid in the fiscal year.
The Act set the assessment percentage rate under the Program for FY 2018-2019 as 2.98% of the net inpatient revenue of the covered hospital and 1.55% of the net outpatient revenue of the covered hospital.3 Subject to conditions specified in 62 P.S. § 813-G, the Department intends to use the revenue derived from this assessment to make medical assistance payment to hospitals in accordance with 62 P.S. § 805-G.
The Department estimates that the FY 2018-2019 assessment for nonexempt hospitals will total $929.451 million. The Department estimates that the FY 2019-2020 through FY 2022-2023 assessment for nonexempt hospitals will total $1,036.063 million annually.
Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. The Department will review and consider comments received within 30 days.
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).
TERESA D. MILLER,
Fiscal Note: 14-NOT-1289. (1) General Fund; (2) Implementing Year 2018-19 is -$929,000,000,000; (3) 1st Succeeding Year 2019-20 through 4th Succeeding Year 2022-23 are -$1,036,000,000; 5th Succeeding Year 2023-24 is $0; (4) 2017-18 Program—$477,690,000; 2016-17 Program—$450,970,000; 2015-16 Program—$392,918,000; (7) Medical Assistance—Fee-for-Service; (8) recommends adoption.
[Pa.B. Doc. No. 18-1801. Filed for public inspection November 16, 2018, 9:00 a.m.]
1 Article VIII-G was added to the law by the act of July 9, 2010 (P.L. 336, No. 49), re-enacted by the act of July 9, 2013 (P.L. 369, No. 55) and amended by the act of December 28, 2015 (P.L. 500, No. 92).
2 The following hospitals are exempt from the assessment: (1) Federal veterans' affairs hospitals; (2) hospitals that provide care, including inpatient hospital services, to all patients free of charge; (3) private psychiatric hospitals; (4) State-owned psychiatric hospitals; (5) critical access hospitals; (6) long-term acute care hospitals; and (7) free-standing acute care hospitals organized primarily for the treatment of and research on cancer in which at least 30% the inpatient admissions had cancer as the principal diagnosis based on Pennsylvania Health Care Cost Containment Council calendar year 2014 inpatient discharge data. For the purposes of meeting the definition of (7), only discharges with ICD-9-CM principal diagnoses codes of 140 through 239, V58.0, V58.1, V66.1, V66.2 or 990 are considered. 62 P.S. § 801-G.
3 The act of June 22, 2018 (P.L. 258, No. 40) also specifies that, for FYs 2019-2020, 2020-2021, 2021-2022 and 2022-2023, the assessment percentage rate under the Statewide Quality Care Assessment Program will be 3.32% the net inpatient revenue of the covered hospital and 1.73% the net outpatient revenue of the covered hospital. The Secretary of Human Services may adjust the assessment percentages for all or part of a fiscal year. 62 P.S. § 803-G.
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