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PA Bulletin, Doc. No. 13-1171


Emergency Department and Outpatient Access Payments

[43 Pa.B. 3581]
[Saturday, June 29, 2013]

 The Department of Public Welfare (Department) is announcing its intent to continue paying the emergency department and outpatient access payments that were initially authorized effective January 1, 2009.


 On July 4, 2008, the General Assembly enacted Article VIII-E of the Public Welfare Code (62 P. S. §§ 801-E—808-E) to authorize the City of Philadelphia to impose, by ordinance, a monetary assessment on the non-Medicare net operating revenue of acute care general hospitals located in the city. This Hospital Assessment Program (Program) was developed to generate additional revenue to fund Medical Assistance (MA) expenditures for hospital outpatient and emergency department services in Philadelphia. The Program also provided additional funding to support the city's public health clinics. The Program was implemented effective January 1, 2009, after receiving the Centers for Medicare and Medicaid Services (CMS) approval for both the assessment and the emergency department and outpatient access payments. The Program was authorized for a 4 1/2-year period which ends effective June 30, 2013, if not reauthorized. The Department, the City of Philadelphia and the hospital community are seeking to reauthorize this Program beyond June 30, 2013.

Continuation of the Hospital Assessment Program

 The Department intends to continue the emergency department and outpatient access payments for an additional 3-year period beginning July 1, 2013, contingent upon CMS approval. If the assessment is approved, the Department does not intend to change its approved State Plan provisions addressing the qualifying criteria or payment methodology for the emergency department and outpatient access payment program.

Fiscal Impact

 The Fiscal Year 2013-2014 impact, as a result of these payments, is $160.904 million ($74.482 million in State general funds and $86.422 million in Federal funds upon approval by CMS).

Public Comment

 Interested persons are invited to submit written comments regarding these proposed changes to the Department of Public Welfare, Office of Medical Assistance Programs, Attention, 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).

Acting Secretary

Fiscal Note: 14-NOT-832. (1) General Fund; (2) Implementing Year 2012-13 is $0; (3) 1st Succeeding Year 2013-14 is $74,482,000; 2nd Succeeding Year 2014-15 is $75,042,000; 3rd Succeeding Year 2015-16 is $75,042,000; 4th Succeeding Year 2016-17 is $0; 5th Succeeding Year 2017-18 is $0; (4) 2011-12 Program—$645,095,000; 2010-11 Program—$467,929,000; 2009-10 Program—$435,939,000; (7) MA—Outpatient; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 13-1171. Filed for public inspection June 28, 2013, 9:00 a.m.]

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