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PA Bulletin, Doc. No. 97-1709


Office of Medical Assistance Programs; Payments to Nursing Facilities

[27 Pa.B. 5545]

   The purpose of this announcement is to provide advance notice under 42 CFR 447.205 that, during fiscal year (FY) 1998-99, the Department of Public Welfare (Department) intends to make changes in its methods and standards for setting payment rates for county nursing facilities by revising 55 Pa. Code § 1187.95(b) to extend the time period for county nursing facility transition rates through June 30, 1999. This notice also announces the Department's intention to enter into an intergovernmental transfer of funds and make county nursing facility supplementation payments to qualifying providers in accordance with the approved State Plan Amendment and 55 Pa. Code § 1187.116 during FY 1997-98.

   The Department is in the process of preparing an agreement with the County Commissioners Association of Pennsylvania which will provide for an intergovernmental transfer of funds for FY 1997-98. As a result of the intergovernmental transfer agreement, the State share of payments for nursing facility Medical Assistance servicesduring FY 1997-98 will be derived, in part, from transfers of funds to the Commonwealth from several counties as authorized under Federal law. (See 42 U.S.C.A. § 1396b(w)(6)(A) and 42 CFR 433.51(b)).

   Under Federal law, the Department is permitted to pay for nursing facility services at rates which, in the aggregate, do not exceed the amount that would be paid for these services under Medicare cost principles. The Department has determined that to the extent it can utilize funds that have been transferred to the Commonwealth by local county governments to contribute towards the payment of nursing facility services at rates which are below the Medicare upper limit, yet higher than the rates that the Department might otherwise pay for these services, the Department will do so.

   The proposed change concerning the extension of the county nursing facility transition rates during FY 1998-99 is contingent upon: (1)  approval by the Federal government of an amendment to Pennsylvania's State Plan authorizing the county nursing facility transition rates through June 30, 1999; (2)  the successful implementation of an intergovernmental transfer during FY 1997-98; and (3)  the Department's implementation of this regulatory change.

   The Department's payment of the county nursing facility supplementation payments for FY 1997-98 is contingent upon: (1) the successful implementation of an intergovernmental transfer during FY 1997-98; and (2) the Department's determination that sufficient state and Federal funds are available to make such payments.

   The estimated increase in annual aggregate expenditures during FY 1997-98 is $148.644 million in total funds ($22.971 million in intergovernmental transfer funds).

   A copy of this notice is available for review at the local County Assistance Offices throughout the Commonwealth. Interested persons are invited to submit written comments about this notice to the Department within 30 days of publication of this notice in the Pennsylvania Bulletin. Comments should be addressed to: Department of Public Welfare, Office of Medical Assistance, Attention: Regulations Coordinator, Room 515 Health and Welfare Building, Harrisburg, PA 17120, (717)787-1870.

   Persons with a disability may use the AT&T Relay Services by calling (800) 654-5984 (TDD Users) or (800) 654-5988 (Voice Users). Persons who require another alternative should contact Thomas Vracarich in the Office of Legal Counsel at (717)783-2209.


[Pa.B. Doc. No. 97-1709. Filed for public inspection October 24, 1997, 9:00 a.m.]

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