§ 1603-T. Resident care and related costs
Purdon's Pennsylvania Statutes and Consolidated StatutesTitle 72 P.S. Taxation and Fiscal AffairsEffective: July 11, 2022
Effective: July 11, 2022
72 P.S. § 1603-T
§ 1603-T. Resident care and related costs
(1) If in any 12-month cost-reporting period a county or nonpublic nursing facility enrolled in the medical assistance program fails to meet the resident care percentage under subsection (a)(1), the Department of Human Services may impose a penalty on the facility up to the difference between the 70% of total costs requirement under paragraph (2) and the percentage spent by the facility on resident care costs or other resident-related costs, but no more than 5%.
(4) The Department of Human Services shall enforce the penalty provisions under this subsection against full 12-month cost reports with reporting periods that begin on or after January 1, 2023, after making the first payment of the increased county and nonpublic nursing facility rates, under both the fee-for-service program and the Community HealthChoices program, beginning January 1, 2023. If the first payment of the increased county and nonpublic nursing facility rates, including payments under both the fee-for-service program and the Community HealthChoices program, is after June 30, 2023, the enforcement of the penalty provisions of this subsection shall commence with the first full 12-month cost report after payment of the increased county and nonpublic nursing facility rates.
(d) Guidelines.--The Department of Human Services may promulgate guidelines, as necessary, to implement this section. The guidelines shall be transmitted to the Legislative Reference Bureau for publication in the Pennsylvania Bulletin. Prior to publication of the guidelines, the Department of Human Services shall consult interested parties. The guidelines under this section shall not be subject to:
(1) Sections 201, 202, 203, 204 and 205 of the act of July 31, 1968 (P.L. 769, No. 240),1 referred to as the Commonwealth Documents Law.
(2) Sections 204(b) and 301(10) of the act of October 15, 1980 (P.L. 950, No. 164),2 known as the Commonwealth Attorneys Act.
(3) The act of June 25, 1982 (P.L. 633, No. 181),3 known as the Regulatory Review Act.
“HAI.” Hospital Acquired Infection.
“MA-11.” The Medical Assistance Financial and Statistical Report for Nursing Facilities and Services submitted to the Department of Human Services by either a county nursing facility or a nonpublic nursing facility for a 12-month cost report period.
“Nonpublic nursing facility.” A nursing facility other than a county nursing facility or a facility owned or operated by the Federal or State Government.
“Schedule C.” The computation and allocation of allowable costs schedule.
“Total MA resident days of care.” The Nursing Facility MA Fee-for-Service days of care and the Nursing Facility MA Community HealthChoices days of care, as reported on the MA-11.
Credits
1929, April 9, P.L. 343, No. 176, art. XVI-T, § 1603-T, added 2022, July 11, P.L. 540, No. 54, § 16, imd. effective.
72 P.S. § 1603-T, PA ST 72 P.S. § 1603-T
Current through Act 10 of the 2024 Regular Session. Some statute sections may be more current, see credits for details.
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