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PA Bulletin, Doc. No. 19-1865



Payments to Nonpublic Nursing Facilities; Adjusted Medical Assistance Day One Incentive Payments for Fiscal Year 2018-2019

[49 Pa.B. 7372]
[Saturday, December 14, 2019]

 The purpose of this notice is to announce that the Department of Human Services (Department) is adjusting the Medical Assistance Day One Incentive (MDOI) payments to each qualified nonpublic nursing facility for Fiscal Year (FY) 2018-2019 because a calculation error was identified.

Nonpublic MDOI Payment Information

 The Department published a notice at 48 Pa.B. 5927 (September 22, 2018) announcing it intended to continue the nonpublic MDOI payments for FY 2018-2019. That notice included qualifying criteria and payment methodology for the nonpublic MDOI payments. Each nursing facility may qualify for a maximum of two payments.

 The Department has identified that the two nonpublic MDOI payments to qualified nursing facilities were underpaid due to a calculation error. Therefore, the Department has recalculated the nonpublic MDOI payments. As a result, each qualified nursing facility has received an adjusted payment to increase their nonpublic MDOI payment amounts. There is no change to qualifying criteria or the payment methodology.

 The adjusted payment information for the nonpublic nursing facility MDOI payments was posted to the Department's web site at


 If a facility wishes to appeal, the facility must file a written request for a hearing with the Department's Bureau of Hearings and Appeals, 2330 Vartan Way, Second Floor, Harrisburg, PA 17110-9721, within 30 days of the date of publication of this notice. A copy should be sent to the Department of Human Services, Office of Long-Term Living, Attention: Bureau of Finance, Division of Rate Setting and Auditing, 555 Walnut Street, Forum Place, 6th Floor, P.O. Box 8025, Harrisburg, PA 17105-8025 and to the Department of Human Services, Office of General Counsel, Health and Welfare Building, Third Floor West, P.O. Box 2675, Harrisburg, PA 17105-2675.

 Appeals of Medical Assistance providers are governed by 55 Pa. Code Chapter 41 (relating to Medical Assistance provider appeal procedures). Individuals should review those regulations carefully. Among other things, they specify what information individuals must include in the written request for hearing and how the Bureau of Hearings and Appeals will determine whether the request for hearing was filed on time.

Questions or Comments

 For questions or comments regarding these payments, contact the Department of Human Services, Office of Long-Term Living, Bureau of Finance, Attention: Diane E. Bamford, (717) 787-1171,


Fiscal Note: 14-NOT-1375. (1) General Fund; (2) Implementing Year 2019-20 is $37,000; (3) 1st Succeeding Year 2020-21 through 5th Succeeding Year 2024-25 are $0; (4) 2018-19 Program—$850,149,000; 2017-18 Program—$1,099,000,000; 2016-17 Program—$1,082,000,000; (7) Long-Term Care; (8) recommends adoption. The Long-Term Care appropriation is able to absorb this increase.

[Pa.B. Doc. No. 19-1865. Filed for public inspection December 13, 2019, 9:00 a.m.]

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