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PA Bulletin, Doc. No. 19-588



Supplemental Payments to Qualifying Hospitals

[49 Pa.B. 1970]
[Saturday, April 20, 2019]

 The Department of Human Services (Department) is announcing its intent to allocate funds for Fiscal Year (FY) 2018-2019 supplemental payments to qualifying acute care general hospitals that provide medical and surgical ocular services to Medical Assistance (MA) beneficiaries to ensure continued access to these critical eye related services.

Qualifying Criteria

 A hospital is eligible for these supplemental payments if the hospital meets all criteria listed as follows:

 a) The hospital is enrolled in MA Program as an acute care general hospital.

 b) The hospital is located in a city of the first class.

 c) The hospital does not qualify as a children's hospital, as defined at 42 CFR 495.302 (relating to definitions).

 d) The hospital has net patient revenue of less than $30 million for FY 2016-2017 as reflected in the Pennsylvania Health Care Cost Containment Council 2017 financial report.

 Payments will be divided proportionately among qualifying hospitals based on the percentage of each qualifying hospital's net patient revenue to total net patient revenue of all qualifying facilities as reflected in the Pennsylvania Health Care Cost Containment Council 2017 financial report.

Fiscal Impact

 The FY 2018-2019 impact, as a result of the intended funding allocation for these payments, is $1.675 million ($0.800 million in State general funds and $0.875 million in Federal funds) upon approval by the Centers for Medicare & Medicaid Services.

Public Comment

 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 in determining the final payment methodology for these payments.

 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-1317. (1) General Fund; (2) Implementing Year 2018-19 is $800,000; (3) 1st Succeeding Year 2019-20 through 5th Succeeding Year 2023-24 are $0; (4) 2017-18 Program—$477,690,000; 2016-17 Program—$450,970,000; 2015-16 Program—$392,918,000; (7) MA—Fee-for-Service; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 19-588. Filed for public inspection April 19, 2019, 9:00 a.m.]

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