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PA Bulletin, Doc. No. 01-2333


Intergovernmental Transfer of Funds; Extension of County Nursing Facility Payments; and Disproportionate Share Payments

[31 Pa.B. 7076]

   The purpose of this announcement is to provide advance notice under 42 CFR 447.205 that during FYs 2003-2007, the Department of Public Welfare (Department) intends to make changes in its payments to nursing facilities participating in the Medical Assistance Program.

   The Department entered into an agreement with the County Commissioners Association of Pennsylvania which authorizes the transfer of funds to the Commonwealth from several counties (as authorized under Federal law (42 U.S.C.A. § 1396b(w)(6)(A) and 42 CFR 433.51(b)). The funds from this intergovernmental transfer (IGT) will be used as the State share for a portion of the county transition payments during FYs 2003-2007 and the disproportionate share incentive to qualified nursing facilities during FYs 2003-2005.

   The Department intends to revise its method for setting payment rates for county nursing facilities participating in the Medical Assistance Program during FYs 2003-2007 to allow for county transition payments to be paid. The payments are currently authorized through June 30, 2003.

   The Department also intends to revise the disproportionate share incentive payments to qualified nursing facilities for FYs 2003-2005. Currently, the disproportionate share per diem is to be doubled during FYs 1999-2003. The IGT of October 1, 2001, states that for FYs 2003-2005, the disproportionate share per diem incentive shall be paid at two times the disproportionate share per diem incentive calculated in accordance with 55 Pa. Code § 1187.111(c) (relating to disproportionate share incentive payments).

   These proposed changes in nursing facility payments during FYs 2003-2007 are contingent upon: (1) approval by the Federal government of amendments to the Commonwealth's State Plan authorizing the county transition payments and the disproportionate share incentive payments; (2) the Commonwealth's receipt of intergovernmental transfers of funds from county governments in amounts sufficient to make these payments; and (3) the promulgation of regulations to permit county transition payments during FYs 2003-2007 and double disproportionate share payments during FYs 2003-2005.

   The estimated increase in annual aggregate expenditures during FYs 2003-2007 is $45.280 million in total funds ($20.657 million in State funds). The Department will publish revisions to 55 Pa. Code Chapter 1187 (relating to nursing facility services) to implement the changes with respect to the county transition payments.

   A copy of this notice is available for review at the local county assistance offices throughout this Commonwealth.

   Interested persons are invited to submit written comments 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 Programs, Attention: Regulations Coordinator, Room 515 Health and Welfare Building, Harrisburg, PA 17105.

   Persons with a disability may use the AT&T Relay Services by calling (800) 654-5984 (TDD users) or (800) 654-5988 (voice users), or may use the Department's TDD by calling (717) 787-3616. Persons who require another alternative should contact Thomas Vracarich at (717) 783-2209.


   Fiscal Note.  14-NOT-307. (1) General Fund; (2) Implementing Year 2001-02 is $0; (3) 1st Succeeding Year 2002-03 is $5,281,000; 2nd Succeeding Year 2003-04 is $8,139,000; 3rd Succeeding Year 2004-05 is $8,420,000; 4th Succeeding Year 2005-06 is $2,021,000; 5th Succeeding Year 2006-07 is $2,077,000; (4) 2000-01 Program--$722,565,000; 1999-00 Program--$693,625,000; 1998-99 Program--$721,631,000; (7) Medical Assistance--Long Term Care; (8) recommends adoption. The proposed changes are dependent upon the Federal government's approval of amendments to Pennsylvania's State Plan authorizing the county transition and disproportionate share payments, receipt of sufficient intergovernmental transfers of funds from county governments and promulgation of regulations permitting county transition and double disproportionate share payments.

[Pa.B. Doc. No. 01-2333. Filed for public inspection December 28, 2001, 9:00 a.m.]

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