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PA Bulletin, Doc. No. 09-587

NOTICES

DEPARTMENT OF
PUBLIC WELFARE

Additional Class of Disproportionate Share Payments for Critical Access Hospitals and Qualifying Rural Hospitals

[39 Pa.B. 1594]
[Saturday, March 28, 2009]

   The Department of Public Welfare (Department) is announcing its intent to establish an additional class of disproportionate share hospital (DSH) payments for qualifying hospitals based on the designation as a Critical Access Hospital (CAH) or as a qualifying rural hospital.

   The Commonwealth is dedicated to ensuring the availability of quality care to recipients in rural areas across this Commonwealth. To maintain the system for rural health services, the Department will establish this additional class of DSH payments for CAHs and qualifying rural hospitals.

   The Department will consider hospitals that have been designated as a CAH to be eligible for this additional class of DSH payments. CAHs are defined as any hospital that has qualified under section 1861(mm)(1) of the Social Security Act (42 U.S.C. § 1395x(mm)(1)) (relating to definitions) as a ''critical access hospital'' under Medicare. The Department will distribute payments to CAHs to reimburse at 101% of the allowable inpatient and outpatient Medical Assistance (MA) costs for services provided to eligible MA recipients, after deducting all other MA payments, including payments for services rendered, DSH payments or other supplemental payments.

   The Department will distribute any remaining program funds to rural hospitals that are an acute care general hospital that is licensed as a hospital under the Health Care Facilities Act (35 P. S. §§ 448.101--448.904b), and meets all of the following:

   (a)  Located in a county of the 6th, 7th or 8th class that has no more than two MA-enrolled acute care general hospitals.

   (b)  Located in a county that has greater than 17% of its population that are eligible for MA or has greater than 10,000 persons eligible for MA.

   (c)  Has no more than 200 licensed and staffed beds.

   (d)  Does not qualify as a CAH under section 1861(mm)(1) of the Social Security Act (42 U.S.C. § 1395x(mm)(1)).

   The Department will distribute any remaining funds to qualifying rural hospitals as follows:

   (a)  50% will be shared equally among the eligible hospitals.

   (b)  50% will be distributed based on each hospital's percent of total MA Fee-for-Service discharges compared to all eligible hospitals total MA Fee-for-Service discharges.

Fiscal Impact

   The Fiscal Year 2008-2009 fiscal impact, as a result of this additional class of DSH payments is $10.748 million ($4.888 million in State General Funds and $5.860 million in Federal Funds upon approval by the Centers for Medicare and Medicaid Services).

Public Comment

   Interested persons are invited to submit written comments regarding this notice to the Department of Public Welfare, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments received within 30 days 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 Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

ESTELLE B. RICHMAN,   
Secretary

   Fiscal Note:  14-NOT-589. (1) General Fund; (2) Implementing Year 2008-09 is $4.888 M; (3) 1st Succeeding Year 2009-10 is $0.000 M; 2nd Succeeding Year 2010-11 is $0.00 M; 3rd Succeeding Year 2011-12 is $0.000 M; 4th Succeeding Year 2012-13 is $0.000 M; 5th Succeeding Year 2013-14 is $ 0.000; (4) 2007-08 Program--$0 M; 2006-07 Program-- $0 M; 2005-06 Program--$0 M; (7) MA--Critical Access Hospitals; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 09-587. Filed for public inspection March 27, 2009, 9:00 a.m.]


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