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PA Bulletin, Doc. No. 02-586



Payments to Nursing Facilities; April 1, 2002 Proposed Rates

[32 Pa.B. 1927]

   The notice announces the proposed changes in nursing facility per diem payment rates reflecting case-mix index (CMI) adjustments only, for nursing facility services provided on or after April 1, 2002, and to identify the methodology and justification for these proposed rates. Under 42 U.S.C.A. § 1902(a)(13)(A), as amended by section 4711 of the Balanced Budget Act of 1997 (Pub. L. No. 105-33), a state must use a public process when it proposes to make changes in payment rates or payment methodologies for nursing facility services under its approved Title XIX State Plan.

   The Department of Public Welfare (Department) has submitted a State Plan Amendment which will, if approved by the Centers for Medicare and Medicaid Services (CMS), change the methods and standards for setting payment rates for nursing facility services relating to movable property. These proposed rates are contingent upon approval of the State Plan Amendment by CMS.


   The proposed rates are available through the local County Assistance Offices throughout this Commonwealth, on the Office of Medical Assistance Programs' website at or by contacting Tom Jayson, Policy Section, Bureau of Long Term Care Programs at (717) 705-3705.


   The methodology that the Department used to set the proposed rates based on CMI adjustments is contained in 55 Pa. Code Chapter 1187, Subchapter G (relating to rate setting), in a final-omitted rulemaking published at 32 Pa.B. 734 (February 9, 2002) and in the Commonwealth's pending Title XIX State Plan which was submitted to CMS on September 21, 2001.


   The rate-setting methodology requires that per diem rates be adjusted for the 2nd, 3rd and 4th quarters of each rate year.

   The estimated increase in annual aggregate expenditures for Medical Assistance nursing facility services for FY 2001-2002 is $4.907 million ($2.238 million in Commonwealth funds).

   Interested persons are invited to submit written comments only concerning CMI adjustments to the proposed rates to the Department within 30 days of publication of this notice in the Pennsylvania Bulletin. Comments should be addressed to Department of Public Welfare, Attention: Suzanne Love, P. O. Box 2675, 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).


   Fiscal Note:  14-NOT-319. (1) General Fund; (2) Implementing Year 2001-02 is $2,238,000; (3) 1st Succeeding Year 2002-03 is $5,371,000; 2nd Succeeding Year 2003-04 is $5,371,000; 3rd Succeeding Year 2004-05 is $5,371,000; 4th Succeeding Year 2005-06 is $5,371,000; 5th Succeeding Year 2006-07 is $5,371,000; (4) 2000-01 Program--$722,565,000; 1999-00 Program--$693,625,000; 1998-99--$712,631,000; (7) Medical Assurance--Long Term Care; (8) recommends adoption. Funds are included in the budget for this purpose.

[Pa.B. Doc. No. 02-586. Filed for public inspection April 12, 2002, 9:00 a.m.]

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