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PA Bulletin, Doc. No. 22-642



Supplemental Payments to Qualifying Hospitals

[52 Pa.B. 2657]
[Saturday, April 30, 2022]

 The Department of Human Services (Department) is announcing its intent to allocate funds in fiscal year (FY) 2021-2022 to establish a new class of supplemental payments to qualifying acute care general hospitals that provide a high volume of services to Medical Assistance (MA) eligible and low-income populations in nonrural medically underserved areas according to the Health Resources and Services Administration as of March 8, 2022. These payments will enable the continuation of quality medical services in these areas.

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 2018-2019 MA-336 Hospital Cost Report, available to the Department on June 22, 2021.

 a) The hospital is enrolled in the Commonwealth's MA Program as an acute care general hospital;

 b) The hospital submitted a FY 2018-2019 MA-336 Hospital Cost Report to the Department available to the Department on June 22, 2021;

 c) The hospital's main campus is located in a county of the third class with a population between 360,000 and 370,000 under the 2010 Federal decennial census (county class for purposes of this payment program as reflected in Classification of Counties, 2010 Census within Section 6 of the Pennsylvania Manual, Volume 121);

 d) The hospital provided over 10,000 inpatient days of care to Commonwealth MA beneficiaries and offered an array of inpatient services to Commonwealth MA beneficiaries as evidenced by having provided at least 150 acute care days, 150 psychiatric days and 150 rehabilitation (medical and drug and alcohol) days to Commonwealth MA beneficiaries; and,

 e) The hospital has less than 300 total available beds.

Payment Methodology

 Payments will be divided proportionately among qualified hospitals based on each hospital's fee-for-service (FFS) MA inpatient acute care days of service to MA beneficiaries in the Commonwealth to total FFS MA inpatient acute care days of service to MA beneficiaries in the Commonwealth for all qualifying hospitals.

Fiscal Impact

 For FY 2021-2022, the Department will allocate an annualized amount of $5.283 million in total funds (State and Federal) for these supplemental payments 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-1508. (1) General Fund; (2) Implementing Year 2021-22 is $1,199,000; (3) 1st Succeeding Year 2022-23 through 5th Succeeding Year 2026-27 are $0; (4) 2020-21 Program—$808,350,000; 2019-20 Program—$344,107,000; 2018-19 Program—$342,544,000; (7) MA—FFS; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 22-642. Filed for public inspection April 29, 2022, 9:00 a.m.]

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