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PA Bulletin, Doc. No. 21-963



Supplemental Payments to Qualifying Hospitals

[51 Pa.B. 3398]
[Saturday, June 19, 2021]

 The Department of Human Services (Department) is announcing its intent to allocate funds for fiscal year (FY) 2020-2021 supplemental payments to qualifying acute care general hospitals that treat a high percentage of Medical Assistance (MA) patients under the age of 18. These payments will enable the continuation of quality medical services for children enrolled in the MA Program.

Qualifying Criteria

 A hospital is eligible for these supplemental payments if the hospital meets all the following criteria. Unless otherwise stated, the source of the information is the FY 2016-2017 MA-336 Hospital Cost Report, as available to the Department on October 29, 2019.

 a) The hospital is enrolled in the Pennsylvania MA Program as an acute care hospital, licensed by the Department of Health (DOH);

 b) The hospital provides acute inpatient services to patient populations predominately under the age of 18. A hospital's patient population is predominately under the age of 18 if the hospital's number of discharges for ''0—17 Years'' is greater than 50% of the hospitals number of ''Total'' discharges. Discharges are determined from the calendar year 2019 DOH Reports 3-A and 3-B;

 c) The hospital is located in a city of the first class; and,

 d) The hospital's ratio of combined MA acute care fee-for-service (FFS) and managed care days to total inpatient acute care days exceeds 70%.

Payment Methodology

 Payments will be divided proportionately among qualified hospitals based on each hospital's FFS Pennsylvania MA inpatient acute care days to total FFS Pennsylvania MA inpatient acute care days for all qualifying hospitals.

Fiscal Impact

 For FY 2020-2021, the Department will allocate an annualized amount of $40.163 million in total funds (State and Federal) upon approval by the Centers for Medicare & Medicaid Services.

Public Comment

 Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. The Department will review and consider comments received within 30 days in determining the final payment methodology for these payments.

 Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania Hamilton Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

Acting Secretary

Fiscal Note: 14-NOT-1444. (1) General Fund; (2) Implementing Year 2020-21 is $0; (3) 1st Succeeding Year 2021-22 is $9,061,000; 2nd Succeeding Year 2022-23 through 5th Succeeding Year 2025-26 are $0; (4) 2019-20 Program—$344,107,000; 2018-19 Program—$342,544,000; 2017-18 Program—$477,690,000; (7) MA—FFS; (8) recommends adoption. Funds have been included in the current budget to cover this increase, which will pay out in the next fiscal year.

[Pa.B. Doc. No. 21-963. Filed for public inspection June 18, 2021, 9:00 a.m.]

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