Payment for Nursing Facility Services Provided by Nonpublic Nursing Facilities; Notice of Change in Methods and Standards of Setting Payment Rates
[38 Pa.B. 3562]
[Saturday, June 28, 2008]
The purpose of this announcement is to provide advance notice that the Department of Public Welfare (Department) intends to amend the Commonwealth's Title XIX State Plan provisions to make changes in its methods and standards for payment of Medical Assistance (MA) nursing facility services for nonpublic nursing facilities for Fiscal Year (FY) 2008-2009.
In July 2006, the Department changed its methods and standards for payments to county nursing facilities to recognize the costs that are incurred by county nursing facilities to provide nursing facility services to MA eligible residents as MA Program expenditures, so long as the costs are allowable under Department regulations and the costs are reported and certified by the county nursing facilities in a form and manner specified by the Department.
To implement this change, the Department promulgated 55 Pa. Code Chapter 1189 (relating to county nursing facility services) for county nursing facilities. Chapter 1189 sets forth the methods and standards that the Department uses to reimburse county nursing facilities. Corresponding amendments were also made to 55 Pa. Code Chapter 1187 (relating to nursing facility services), to make the chapter applicable solely to nonpublic nursing facilities. To mitigate the impact of these changes on the rates of nonpublic nursing facilities, the Department amended the case-mix payment system set forth in Chapter 1187 to continue to include county nursing facilities in the process of computing the peer group prices used to set per diem rates for nonpublic facilities for the 2006-2007 and 2007-2008 rate years.
The Department proposes to continue to include county nursing facilities in the process of computing the peer group prices used to set per diem rates for nonpublic facilities for rate year 2008-2009.
In addition, the current provisions contained in § 1187.97(2) (relating to rates for new nursing facilities with a change of ownership, reorganized nursing facilities, and former prospective payment nursing facilities) only addresses payment for county nursing facilities that privatize between July 1, 2006 and June 30, 2008. The Department is proposing to extend this time frame through FY 2008-2009.
To authorize the continuation of these provisions for FY 2008-2009, the Department will submit a State Plan Amendment (SPA) to the Federal Centers for Medicare and Medicaid Services (CMS).
Contingent upon the approval by CMS of the SPA, the Department will continue to include county nursing facilities in the process of computing the peer group prices used to set per diem rates for nonpublic facilities for rate year 2008-2009 and calculate rates for county nursing facilities that privatize as set forth in § 1187.97(2).
No fiscal impact is anticipated as a result of the proposed rates in FY 2008-2009.
Interested persons are invited to submit written comments regarding this notice to the Department of Public Welfare, Office of Long-Term Living, Attention Gail Weidman, P. O. Box 2675, Harrisburg, PA 17105. Comments received within 30 days of publication of this notice in the Pennsylvania Bulletin will be reviewed and considered for any subsequent revision of the notice.
Persons with a disability who require an auxiliary aid or service may submit comments using the AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
ESTELLE B. RICHMAN,
Fiscal Note:14-NOT-562. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 08-1220. Filed for public inspection June 27, 2008, 9:00 a.m.]
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