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COMMONWEALTH OF PENNSYLVANIA

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PA Bulletin, Doc. No. 03-1323b

[33 Pa.B. 3186]

[Continued from previous Web Page]

Regulation Being
Considered
Proposed Date
of Promulgation
Need and Legal Basis for Action Agency Contact
INFRASTRUCTURE INVESTMENT AUTHORITY
25 Pa. Code §§ 963.12(a)(6), 963.13(b) 2, 963.15(a), and 25 Pa. Code § 965.4((9). Fall of 2003 PENNVEST recommends the following revisions: (1) Delete Section 963.12(a) (6) and the second sentence of Section 963.13(b)(2) thereby allowing PENNVEST to provide financial assistance (loan or grant) for costs associated with the development of an approvable official sewage plan under the Sewage Facilities Act, 35 P. S. § 750.1 et seq. While PENNVEST has always construed these costs to be encompassed with in the statutory definition of ''eligible cost'' (35 P. S. § 751.3), the agency chose as a matter of policy not to fund this planning process because the Pennsylvania Department of Environmental Protection already provided grant funds for 50% of these costs. PENNVEST is revising its policy because the agency is concerned that, in some instances, needed projects are unable to move forward in a timely manner due to a lack of funds to conduct this necessary planning. PENNVEST, therefore, is removing the impediment to funding imposed by the above regulatory provisions. (2) Amend 25 Pa. Code § 963.15(a) by revising the first sentence to read in its entirety: ''The term of the loans shall normally be twenty years beginning on the date construction is completed or three years from of the date of loan closing, whichever occurs first.'' This amendment provides a level loan repayment and a defined term at loan closing (normally twenty years). Under the old policy the loan term was determined sometime in the future after construction closed out. Consequently, under the old policy a Borrower with a project that took two years to construct would have had only eighteen years to repay the loan. Under the new policy the repayment term would be twenty years plus two years of interest only payments to provide for construction. (3) Amend 25 Pa. Code § 965.4 (9) to place a period after the word ''Board'' and delete the remainder of the sentence. This amendment allows those costs associated with the acquisition of land under the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 to be financed by PENNVEST. This change is necessary to reflect a shift in policy by the Environmental Protection Agency and the desire of PENNVEST to take advantage of the policy shift to finance such costs. Jayne B. Blake (717)-783-6776
INSURANCE
Producer Licensing, 31 Pa. Code, Chapter 37, §§ 37.1--37.84 Fall/Winter 2003, as proposed. Act 147 of 2002 sets new standards for Producers in the Commonwealth. This chapter will be updated to be consistent with the statute. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Advertising of Insurance, 31 Pa. Code, Chapter 51, §§ 51.1--51.61 Winter 2003, as proposed. Amend pursuant to Executive Order 1996-1. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Private Passenger Automobile Policy Forms, 31 Pa. Code, Chapter 64, §§ 64.1--64.14 Fall 2003, as proposed. Repeal pursuant to Executive Order 1996-1. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Motor Vehicle Financial Responsibility Law--Evidence of Financial Responsibility, 31 Pa. Code, Chapter 67, §§ 67.21--28 Fall 2003, as proposed. Amend to make the regulation consistent with statutory requirements. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Replace Life Insurance Annuities, 31 Pa. Code, Chapter 81, §§ 81.1--9 Winter 2003, as proposed. Amend pursuant to Executive Order 1996-1. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Variable Life Insurance, 31 Pa. Code, Chapter 82, §§ 82.1--91 Fall 2004, as proposed. Amend pursuant to Executive Order 1996-1. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Disclosure in Solicitation of Life Insurance, 31 Pa. Code, Chapter 83, §§ 83.1--57 Fall 2003, as proposed. Amend pursuant to Executive Order 1996-1. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Annuity Disclosure, (NEW Chapter 83a) Winter 2003, as final. A new regulation to eliminate misleading illustrations, make illustrations more understandable and to standardize the disclosure statement language to be use with the selling of annuities. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Variable Annuity and Accumulation Contracts, 31 Pa. Code, Chapter 85, §§ 85.1--85.40 Fall 2004, as proposed. Amend pursuant to Executive Order 1996-1. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Requirements for Life Policies and Sales Practices, 31 Pa. Code, Chapter 87, §§ 87.1--87.42 Spring 2004, as proposed. Amend pursuant to Executive Order 1996-1. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Life Insurance Illustrations (New Chapter 87a) Winter 2003, as proposed. Act 154 of 1996 provides for life insurance illustration requirements for life insurance policies. The statute sunsets when a life insurance illustration regulation becomes effective. A life insurance illustration regulation will eliminate misleading illustrations, make illustrations more understandable, and standardize terms and illustration formats for the entire life insurance industry. Further, it is more appropriate that technical requirements, such as these, appear in a regulation rather than in statutory form. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Individual Accident and Sickness Minimum Standards, 31 Pa. Code, Chapter 88, §§ 88.1--88.195 Winter 2003, as proposed. Amend pursuant to Executive Order 1996-1. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Preparation of Forms, 31 Pa. Code, Chapter 89, §§ 89.12--16, 89.18--89.62 Spring 2004, as proposed. Amend pursuant to Executive Order 1996-1. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Prior Approval of Forms Required, 31 Pa. Code, Chapter 89, § 89.101 Spring 2004, as proposed. Amend pursuant to Executive Order 1996-1. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Preparation of Filing of Property and Casualty Forms for Approval, 31 Pa. Code, Chapter 133, §§ 133.1--133.12 Winter 2003, as proposed. Repeal pursuant to Executive Order 1996-1. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Description of Reserves--Prohibited Phrases, 31 Pa. Code, Chapter 139, §§ 139.1--139.3 Spring 2004, as proposed. Amend pursuant to Executive Order 1996-1. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Unfair Insurance Practices; Unfair Claims Settlement Practices, 31 Pa. Code, Chapter 146, §§ 146.1--146.10 Fall 2003, as proposed. Amend pursuant to Executive Order 1996-1. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Standards for Safeguarding Customer Information, NEW 31 Pa. Code, Chapter 146c, 146c.1--146c.11 Summer 2003, as proposed. NEW. This implements the third part of the NAIC model privacy regulation with respect to safeguarding customer information. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Annual Audited Insurers' Financial Report Required, 31 Pa. Code, Chapter 147 Summer 2003, as proposed. Amend to prohibit a person or firm from being recognized as a qualified independent certified public accountant if the person or firm has entered into an agreement of indemnity or release from liability with respect to an audit of an insurer. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Funds Held as Security for the Payment of Obligations of Unlicensed, Unqualified Reinsurers, 31 Pa. Code, Chapter 163 §§ 163.1--163.20 Fall 2003, as proposed Amend to update provisions relating to trust agreements and letters of credit. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Health Maintenance Organizations, 31 Pa Code, Chapters 301, §§ 301.1--301.126 Winter 2003, as proposed. Amend pursuant to Executive Order 1996-1. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Premium Finance Companies (New Chapter) Summer 2003, as proposed. New regulation addressing issues pertaining to Premium Finance Companies. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
Viatical Regulations (New Chapter) Spring 2004, as proposed. New regulation addressing issues pertaining to the Licensing of Viatical Brokers. Peter J. Salvatore, Regulatory Coordinator 717-787-4429
LABOR AND INDUSTRY
Underground Storage Facilities, Title 34 Labor and Industry Regulations Bureau of Occupational and Industrial Safety will submit as proposed rulemaking in Spring 2003. This regulation will address requirements for natural or man-made caverns used for LPG storage. Edward Leister 717-787-3323
Dry Cleaning Will be addressed through Act 45 regulations. (See Act 45 regulations below.) Dry Cleaning Law, Act of December 19, 1990, P. L. 1327, No. 214, 35 P. S. 1270.1 et seq. This proposal will regulate the construction, operation and maintenance of dry cleaning plants. Edward Leister 717-787-3323
Elevators and Lifting Devices Will be addressed through Act 45 regulations. (See Act 45 regulations below.) The new regulation will amend the current standards to include ANSI/ASME A17.1, B20.1 and other national consensus standards. There is a need to update standards to bring them in line with national standards. Edward Leister 717-787-3323
Unemployment Compensation Appeals, Title 34, Labor and Industry Regulations Unemployment Compensation Board of Review published proposed rulemaking in September 2002. Final-form regulation will be submitted Summer 2003 The regulation will update filings with the Board to reflect new technologies and to expedite proceedings. Kelly K. Smith 717-783-5027
Uniform Construction Code (UCC) regulations. Act 45 of 1999. Title 34, Labor and Industry Regulations. Withdrew on 6/9/03 in order to address legislative concerns--will be resubmitted ASAP Act 45 of 1999, providing for a uniform statewide building code, requires department to promulgate regulations. The regulation will provide for administration and enforcement of statewide building code. Because this measure in effect repealed the Dry Cleaning Law, Elevator Law and Fire and Panic Act, the regulations pursuant to each (including those for Personal Care Homes), will be addressed through regulations for Act 45. Jon Balson 717-787-3323
Repeal of mine and excavation regulations, Title 34, Labor and Industry Regulations. Bureau of Occupational and Industrial Safety will submit final-omitted regulation in Summer 2003. Will revoke Labor and Industry's authority to regulate mines and excavations. The Department of Environmental Protection now has this authority, Edward Leister 717-787-3323
Boiler requirements, Title 34 Labor and Industry Regulations. Bureau of Occupational and Industrial Safety will submit proposed rulemaking in Summer 2003. The regulations will update requirements for boilers and unfired pressure vessels in accordance with the Boiler and Unfired Pressure Vessel Law. Edward Leister 717-787-3323
Liquefied Petroleum Gas, Title 34 Labor and Industry Regulations. Bureau of Occupational and Industrial Safety will submit proposed rulemaking in Summer 2003. Will enact the Propane and Liquefied Petroleum Gas Act passed in June 2002. Will govern the design, installation and construction of containers and equipment for storage and handling of liquefied petroleum gas, specify the odorization of the gases and establish guidelines for the processing and technologies that are not covered by industry standards. Edward Leister 717-787-3323
Business Enterprise Program, Title 34 Labor and Industry Regulations Bureau of Blindness and Visual Services will submit proposed rulemaking in Summer 2003 Concerns operation of snack bars and similar operations in Commonwealth facilities under the Federal Randolph-Sheppard Act and related Pennsylvania laws. Mark Frankel 717-787-3667
MILITARY AND VETERANS AFFAIRS
State Veterans Home
43 Pa. Code Section 7.1 et seq
October 2003, as proposed. This regulation is necessary to update current regulations to make them more user-friendly. This regulation is a long-term project and would amend 43 Pa. Code Chapter 7. Eclemus Wright, Jr.
717-861-8503
PENNSYLVANIA MUNICIPAL RETIREMENT SYSTEM
See Public School Employees' Retirement System.
PROBATION AND PAROLE
No regulations being developed or considered at this date.
PUBLIC SCHOOL EMPLOYEES' RETIREMENT SYSTEM
22 Pa. Code
Chapter 215
Publication anticipated within 2-3 months This proposal is being made to amend 22 Pa. Code, Chapter 215 and would delete the transitional provisions for electing to participate in an optional alternate retirement plan contained in § 215.36. The provision is no longer needed, and may conflict with current Retirement Code provisions. Frank Ryder (717) 720-4733
PUBLIC WELFARE
Personal Care Homes
55 Pa. Code Chapters 2600, 2620
February 2004, as final This regulation strengthens health and safety requirements for personal care homes. Ruth O'Brien (717) 783-2800
Administration of County Children and Youth Programs
55 Pa. Code Chapter 3130
January 2004, as proposed This regulation incorporates the amendments to the Juvenile Act as a result of Act 126 of 1998 and the federal regulations (effective March 27, 2000) for Title IV-B and Title IV-E funding for child welfare services for children in their own homes and for children receiving placement services. Major changes include permanency hearings and the matters to be determined, requirements related to reasonable efforts including aggravated circumstances contrary to the welfare and best interests and redefining permanency goals for children. Ruth O'Brien (717) 783-2800
Subsidized Child Day Care Eligibility
55 Pa. Code Chapter 3040
November 2003, as proposed This regulation clarifies and revises the eligibility requirements for child day care subsidy. Ruth O'Brien (717) 783-2800
Administration and Operation of a Children and Youth Social Services Agency
55 Pa. Code Chapter 3680
August 2004, as proposed This regulation incorporates the changes identified in the Child and Family Services Review, including requirements for visitation with fathers and non-custodial parents and between siblings; concurrent planning; improving permanency outcomes for children; and preserving connections with family and community for children placed out of the home. Ruth O'Brien (717) 783-2800
Workfare/Community Service
55 Pa. Code Chapters 166, 275
January 2004, as proposed This regulation clarifies who may be assigned and the priority and factors to be considered in making Workfare program assignments. The regulation also defines responsibilities of county assistance offices and project operators regarding participation expenses and program requirements and provides for grievance rights for Workfare recipients and regular employees. Provisions of Act 1995-20 will also be incorporated into this regulation. This regulation will be reviewed by representatives of community legal services agencies, the welfare rights organization and other client advocacy groups. Ruth O'Brien (717) 783-2800
Real Property Liens
55 Pa. Code Chapters 101, 121, 177, 183, 257, 297
January 2004, as proposed This regulation codifies the elimination of the requirement that applicants who own real property, including mobile homes, which are used as their primary residence, will no longer be required to sign a lien encumbering their residence as a condition of eligibility for cash assistance. The Department intends to rescind 55 Pa. Code Chapter 257 (relating to Reimbursement). Instead, the Department will propose a new chapter governing reimbursement policy for cash assistance recipients and applicants who own personal property. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization and other client advocacy groups. Ruth O'Brien (717) 783-2800
Criminal History *
55 Pa. Code Chapters 125, 133, 141
January 2004, as proposed This regulation incorporates the Act 1995-20 provision that prohibits the granting of assistance to any person sentenced for a felony or misdemeanor who has not satisfied the penalty imposed by law by having completed the period of incarceration and by paying all fines, costs and restitution. Act 1996-35 expands the satisfied penalty requirement to include compliance with an approved payment plan. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization and other client advocacy groups. Ruth O'Brien (717) 783-2800
Medical Support Rights
55 Pa. Code Chapter 187
January 2004, as proposed This regulation will require Medical Assistance applicants recipients to assign their medical support rights to the Commonwealth and apply for Title IV-D support services as conditions of eligibility. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization and other client advocacy groups. Ruth O'Brien (717) 783-2800
Food Stamp Disqualification Penalties
55 Pa. Code Chapter 501
January 2004, as proposed This regulation incorporates a revision to the Food Stamp disqualification penalties as required under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA). The revision increases the Food Stamp intentional program violation disqualification penalties from six months to one year for the first violation and from one year to two years for the second violation. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization and other client advocacy groups. Ruth O'Brien (717) 783-2800
Family Violence Option
55 Pa. Code Chapter 187
January 2004, as proposed This regulation codifies the provision in the TANF State Plan to screen and identify victims of domestic violence, refer those individuals to counseling and supportive services, establish service plans, provide universal notification and make appropriate referrals to social service agencies. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization and other client advocacy groups. Ruth O'Brien (717) 783-2800
Lump Sum Income (Cash)
55 Pa. Code Chapter 183
August 2003, as final This regulation codifies provisions to specify that lump sum is considered income in the month of receipt and a resource in subsequent months. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other client advocacy groups. Ruth O'Brien (717) 783-2800
Increases in Payment for Burial and/or Cremation*
55 Pa. Code Chapter 285
September 2003, as proposed This regulation codifies an increase to the maximum payment for burial and/or cremation for eligible persons. A deceased person of any age who received or was eligible to receive a money payment--TANF, General Assistance, State Blind Pension, or Supplemental Security Income--may be eligible for a maximum burial and/or cremation payment of $750, if there are no resources that reduce the payment. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization and other client advocacy groups. Ruth O'Brien (717) 783-2800
Medical Assistance for Workers with Disabilities
55 Pa. Code Chapter 140
September 2003, as proposed This regulation provides Medicaid benefits to Workers with Disabilities (MAWD) who would otherwise not be eligible, effective January 1, 2002. The Ticket to Work and Work Incentives Improvement Act of 1999 (P. L. 106-170) gave states the option of providing categorically needy Non-Money Payment Medicaid benefits to workers with disabilities who have higher incomes and resources than the current Medicaid standards. Pennsylvania exercised this option by passing Act 2001-77 of June 26, 2001 (P. L. 755), also known as the Tobacco Settlement Act, which establishes MAWD. MAWD is intended to provide individuals with disabilities the opportunity to enter and remain in the workforce while receiving Medicaid coverage. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, disability advocacy organizations and other client advocacy groups. Ruth O'Brien (717) 783-2800
Breast and Cervical Cancer Prevention and Treatment Program
55 Pa. Code Chapter 140
September 2003, as proposed This regulation provides Medicaid benefits to individuals diagnosed with Breast and Cervical Cancer, effective January 1, 2002. The BCCPT Act of 2000 amended Title XIX of the Social Security Act by giving states the option of providing full Medicaid benefits to a new group of individuals. This regulation provides Medical Assistance for women who have breast and cervical cancer, including pre-cancerous conditions of the breast and cervix, in addition to full Medicaid benefits. Specifically, uninsured and underinsured women under the age of 65, screened and diagnosed with either breast or cervical cancer, including pre-cancerous conditions of the breast or cervix, by a provider or facility funded in full or part by the Centers for Disease Control and Prevention under its National Breast and Cervical Cancer Early Detection Program, will be eligible for Medicaid benefits. Pennsylvania has chosen the Department of Health Healthy Woman Project as the screening entity for this program. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, professional medical organizations and other client advocacy groups. Ruth O'Brien (717) 783-2800
Semi-annual Budgeting
55 Pa. Code Chapters 142, 168, 175, and 183
January 2004, as proposed This regulation will change the manner of reporting and adjusting earned income for employed clients. Reporting of earned income will be required for specific periods within six-month intervals. Benefits will be adjusted on a post-adjustment basis so that income reported for period A will affect benefits received in period B, etc. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization and other client advocacy groups. Ruth O'Brien (717) 783-2800
Limitations in Spend-down Eligibility
55 Pa. Code Chapter 181
January 2004, as final This regulation will change the spend-down procedure within the Medicaid eligibility determination process. The change will affect the Medically Needy Only category by limiting unpaid medical expenses used as a deduction to those incurred during the retroactive period. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization and other client advocacy groups. Ruth O'Brien (717) 783-2800
Changes in Nursing Care Eligibility
55 Pa. Code Chapters 178 and 181
January 2004, as final This regulation will change the eligibility requirements for applicants and recipients in long-term care facilities. Recipients of Medicaid Program benefits will be required to contribute more toward the cost of long-term care services. Applicants for Medicaid Program benefits will be required to use more of their own resources to pay for their care prior to being authorized eligible for the Medicaid Program. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, long term care provider organizations and other client advocacy groups. Ruth O'Brien (717) 783-2800
Medical Assistance Changes (MAC)
55 Pa. Code Chapters 133, 140, 141, 178 and 181
December 2003, as proposed This regulation incorporates eligibility requirements for Temporary Assistance for Needy Families (TANF)-related, Supplemental Security Income (SSI)-related and General Assistance (GA)-related Medicaid. Some of the major changes include revisions to: 1) the application and redetermination process; 2) the qualification requirements and eligibility rules for Healthy Beginnings; 3) the income eligibility methodologies for TANF-related categories of Medicaid; 4) the income and resource requirements for the Medicaid Program; 5) Extended Medical Coverage to include provisions as set forth in the Personal Responsibility and Work Opportunity Reconciliation Act of 1966 (PRWORA); 6) the GA-related Nonmoney Payment (NMP) and Medically Needy Only (MNO) eligibility criteria as set forth in Act 35; 7) the qualifying criteria for TANF-related categories to include a new eligibility group as set forth in § 1931 of the Social Security Act. Ruth O'Brien (717) 783-2800
Early and Periodic Screening Diagnosis Treatment (EPSDT) *
55 Pa. Code Chapters 1101, 1121, 1123, 1147, 1241
December 2003, as final omitted This regulation relating to services provided as a follow-up to an EPSDT visit or encounter that are not currently recognized under the approved Medical Assistance State Plan. This regulation will be reviewed by the Medical Assistance Advisory Committee. Ruth O'Brien (717) 783-2800
Medical Assistance Case Management Services *
55 Pa. Code Chapter 1239
January 2004, as final omitted This final regulation codifies payment for medically necessary case management services as mandated by Omnibus Budget Reconciliation Act '89 to Medical Assistance recipients under the age of 21. This regulation will be reviewed by the Medical Assistance Advisory Committee. Ruth O'Brien (717) 783-2800
OMNIBUS MA *
55 Pa. Code Chapters 1101, 1121, 1149
December 2003, as final omitted This final regulation codifies Act 1994-49 provisions that affect the medical benefits of General Assistance recipients over the age of 21 when these services are solely state funded. These recipients are no longer eligible for (1) dental services unless their medical condition or handicap requires services to be provided in an ambulatory surgical center, short procedures unit or inpatient hospital; (2) medical supplies and equipment except as prescribed for family planning or with home health agency service and (3) prescription drugs except legend birth control drugs. This regulation also implements Act 1996-35 provisions imposing a $150 deductible on inpatient and outpatient hospital services and ambulatory surgical center services, except laboratory and x-ray services for General Assistance and General Assistance-related Medical Assistance recipients. In addition, this regulation removes family planning clinics from the list of providers limited under the General Assistance Basic Health Care Package to 18 practitioner's office and clinic visits per year. This regulation will be reviewed by the Medical Assistance Advisory Committee. Ruth O'Brien (717) 783-2800
OMNIBUS Pharmacy *
55 Pa. Code Chapters 1121, 1126, 1129, 1141, 1163, 1221, 1225, 1243
December 2003, as final omitted This final regulation codifies Act 1994-49 provisions that discontinue payment for all drugs, devices, products, services and procedures that are used or related to treating infertility, including surrogacy services, effective September 1, 1994. This regulation also provides that the medical assistance program provides drug coverage to medically needy only recipients receiving nursing facility services. This includes medically needy only recipients who reside in nursing facilities and intermediate care facilities/mental retardation (ICF/MR). This regulation was reviewed by the Medical Assistance Advisory Committee in 2001. Ruth O'Brien (717) 783-2800
Residential Treatment Facilities (RTF) for Mental Health Services*
55 Pa. Code Chapters 1157, 1165
December 2003, as proposed This regulation codifies coverage for mental health services to children under 21 years of age that are provided in a residential treatment facility. This regulation was reviewed by the Medical Assistance Advisory Committee on 3/28/02. The Department received comments from 6 agencies. These comments are currently under review by the Department. Ruth O'Brien (717) 783-2800
Physician Assistant/Midwife*
55 Pa. Code Chapter 1141
December 2003, as final omitted This final regulation codifies revised supervision requirements for physician assistants and midwives. This regulation will be reviewed by the Medical Assistance Advisory Committee. Ruth O'Brien (717) 783-2800
Discontinuance of the Mandatory Second Opinion Program*
55 Pa. Code Chapter 1150
December 2003, as final omitted This final regulation removes the mandatory second opinion program requirement for certain surgical procedures. This regulation will be reviewed by the Medical Assistance Advisory Committee. Ruth O'Brien (717) 783-2800
Capital Component Payment for Replacement Beds
55 Pa. Code Chapter 1187
July 2004, as proposed This regulation takes the policy as set forth in the Statement of Policy published at 27 Pa.B. 6238 (November 29, 1997) and promulgates it into the regulations. This regulation will specify the conditions under which the Department will recognize nursing facility beds as replacement beds for purposes of making capital component payments for those beds. This regulation will be reviewed by the Medical Assistance Advisory Committee. Ruth O'Brien (717) 783-2800
New Definition of ''Emergency Medical Condition'' *
55 Pa. Code Chapters 1101, 1141, 1150, 1221
October 2003, as final omitted This final regulation codifies the revised definition of ''emergency medical condition'' contained in the Balanced Budget Act of 1997, effective July 1, 1998. This regulation will be reviewed by the Medical Assistance Advisory Committee. Ruth O'Brien (717) 783-2800
Definition of Medically Necessary
55 Pa. Code Chapter 1101
December 2003, as proposed This proposed regulation replaces the current definition of ''medically necessary'' with the definition found in the HealthChoices Request for Proposal. This regulation was reviewed on 9/21/01 by the Medical Assistance Advisory Committee. Ruth O'Brien (717) 783-2800
Tobacco Cessation and Nutritional Supplements
55 Pa. Code Chapter 1121
December 2003, as final omitted This final regulation will provide coverage under the Medical Assistance Program for tobacco cessation products and counseling services and will extend coverage for nutritional supplements to eligible Medical Assistance recipients 21 years of age and older. This regulation will be reviewed by the Medical Assistance Advisory Committee. Ruth O'Brien (717) 783-2800
Dental Services
55 Pa. Code Chapter 1149
September 2003, as final omitted This final regulation will provide coverage for crown core build-up and will revise the Medical Assistance Orthodontia Program. This regulation will be reviewed by the Medical Assistance Advisory Committee. Ruth O'Brien (717) 783-2800
Preadmission Requirements for Nursing Facility Services
(Mandatory 12 month spend-down)
55 Pa. Code Chapter 1187
September 2003, as proposed This regulation will require nursing facilities to have all individuals applying for nursing facility services, evaluated by the Department or an independent assessor if it is likely that the applicant will use Medical Assistance as a payer source within 12 months of admission. The purpose of this regulation is to allow an individual to remain in the community by delaying or eliminating the need for admission to a nursing facility. This regulation will be reviewed by the Medical Assistance Advisory Committee. Ruth O'Brien (717) 783-2800
Penile Prosthesis
55 Pa. Code Chapters 1141, 1163,
December 2003, as proposed This regulation revises the current § 1141.59(8) noncompensable services and § 1163.59(a)(4) noncompensable services, items and outliers days. Ruth O'Brien (717) 783-2800
Miscellaneous Case Mix Changes
55 Pa. Code Chapter 1187
November 2003, as proposed This regulation clarifies existing definitions and adds new definitions. The amendments include requirements for multiple-site and single-site licensed nursing facilities regarding certification, enrollment, participation, peer group medians, prices and per diem rates. This regulation also clarifies existing policies relating to the method of indexing costs in the database used for rate setting, the treatment of gross adjustments and the reopening of nursing facility cost report audits. Ruth O'Brien (717) 783-2800
Pharmaceutical Services
55 Pa. Code Chapter 1121
October 2003, as final This regulation revises the rates paid by the Department to pharmacy providers governing payment for and dispensing of brand-name prescription drugs under the fee for service component of the Medical Assistance Program. Ruth O'Brien (717) 783-2800
Nursing Facility Per Diem Rate
Limitation (Emergency regulation)
55 Pa. Code Chapter 1187
September 2003, as final omitted This regulation will change the methods and standards for setting nursing facility case-mix per diem rates. The Commonwealth's budget deficit makes it necessary for the Department to reduce Medical Assistance nursing facility payments. Ruth O'Brien (717) 783-2800
Nursing Facility Assessments
55 Pa. Code Chapter 1187
January 2004, as final omitted This regulation will provide that the nursing facility assessment imposed by legislation may be reported on the cost report as an allowable cost. Ruth O'Brien (717) 783-2800
Extension of County Transition Payments and Double Disproportionate Share
55 Pa. Code Chapter 1187
January 2004, as final omitted This regulation will extend the county nursing facility transition rates for the period July 1, 2003, through June 30, 2008, and will increase the disproportionate share incentive payments to qualified nursing facilities for the period July 1, 2003 through June 30, 2007. The disproportionate share incentive payment shall be increased to equal two times the disproportionate share per diem incentive calculated in accordance with 55 Pa. Code Chapter 1187 § 1187.111(c). This regulation will be reviewed by the Medical Assistance Advisory Committee. These changes are made in accordance with the Intergovernmental Transfer Agreements.

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