pa-56-24-841: Disproportionate share hospital payments to qualifying hospitals

Summary

The Department of Human Services (Department) is announcing its intent to establish a new class of disproportionate share hospital (DSH) payments for Fiscal Year (FY) 2025-2026 to distribute funds to qualifying Medical Assistance (MA) enrolled hospitals to promote additional access in inpatient and ancillary outpatient services and to support academic medical programs for integrated patient centered medical services. Qualifying Criteria The Department determines a hospital eligible for this additional class of DSH payment if the hospital meets all of the criteria as follows. Unless otherwise stated, the source of the information is the State FY 2021-2022 hospital cost report (MA-336). a) The hospital is enrolled in the Pennsylvania (PA) MA Program as a general acute care hospital; b) The hospital is accredited as a Level I Trauma Center and a member of the Children's Hospital Association; c) The hospital's PA MA Fee-for-Service and PA Medicaid Managed Care Medical Education costs exceed $500,000; d) The hospital's Low-income Utilization Rate as reported on its MA-336 exceeds 20%; e) The hospital has a medical school in a county of the third class in a municipality of less than 5,000 residents under the 2020 Federal decennial census; and f) The hospital is operating campuses under the same license with acute care hospitals in a County of the Sixth Class and an acute care hospital in the City of the Third Class in a County of a Third Class as of State FY 2023-2024 as...

The agency’s own summary, as published.