PRINTER'S NO. 913
No. 840 Session of 1993
INTRODUCED BY BELAN, SCANLON AND BODACK, MARCH 30, 1993
REFERRED TO PUBLIC HEALTH AND WELFARE, MARCH 30, 1993
AN ACT
1 Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
2 act to consolidate, editorially revise, and codify the public
3 welfare laws of the Commonwealth," further providing for
4 medical assistance payments made in behalf of eligible
5 persons receiving institutional care in skilled nursing and
6 intermediate care facilities.
7 The General Assembly of the Commonwealth of Pennsylvania
8 hereby enacts as follows:
9 Section 1. Section 443.1 of the act of June 13, 1967
10 (P.L.31, No.21), known as the Public Welfare Code, amended July
11 15, 1976 (P.L.993, No.202), is amended to read:
12 Section 443.1. Medical Assistance Payments for Institutional
13 Care.--The following medical assistance payments shall be made
14 in behalf of eligible persons whose institutional care is
15 prescribed by physicians:
16 (1) The reasonable cost of inpatient hospital care, as
17 specified by regulations of the department adopted under Title
18 XIX of the Federal Social Security Act and certified to the
19 department by the Auditor General for a bed patient on a
1 continuous twenty-four hour a day basis in a multi bed
2 accommodation of a hospital, exclusive of a hospital or distinct
3 part of a hospital wherein twenty-five percent of patients
4 remain six months or more. To be eligible for such payments a
5 hospital must be qualified to participate under Title XIX of the
6 Federal Social Security Act and have entered into a written
7 agreement with the department regarding matters designated by
8 the secretary as necessary to efficient administration, such as
9 hospital utilization, maintenance of proper cost accounting
10 records and access to patients' records. Such efficient
11 administration shall require the department to permit
12 participating hospitals to utilize the same fiscal intermediary
13 for this Title XIX program as such hospitals use for the Title
14 XVIII program;
15 (2) The cost of skilled nursing and intermediate nursing
16 care in State-owned geriatric centers, institutions for the
17 mentally retarded, institutions for the mentally ill, and in
18 county homes which meet the State and Federal requirements for
19 participation under Title XIX of the Federal Social Security Act
20 and which are approved by the department. This cost in county
21 homes shall be as specified by the regulations of the department
22 adopted under Title XIX of the Federal Social Security Act and
23 certified to the department by the Auditor General; elsewhere
24 the cost shall be determined by the department;
25 (3) Rates on a cost-related basis established by the
26 department for skilled nursing home or intermediate care in a
27 non-public nursing home, when furnished by a nursing home
28 licensed or approved by the department and qualified to
29 participate under Title XIX of the Federal Social Security Act;
30 (4) The cost of care in any mental hospital or in a public
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1 tuberculosis hospital. To be eligible for such payments a
2 hospital must be qualified to participate under Title XIX of the
3 Federal Social Security Act and have entered into a written
4 agreement with the department regarding matters designated by
5 the secretary as necessary to efficient administration, such as
6 hospital utilization, maintenance of proper cost accounting
7 records and access to patients' records. Care in a private
8 mental hospital shall be limited to sixty days in a benefit
9 period. Only persons aged twenty-one years or under and aged
10 sixty-five years or older shall be eligible for care in a public
11 mental or tuberculosis hospital. This cost shall be the
12 reasonable cost, as determined by the department for a State
13 institution or as specified by regulations of the department
14 adopted under Title XIX of the Federal Social Security Act and
15 certified to the department by the Auditor General for county
16 and non-public institutions[.];
17 (5) In determining the cost of skilled nursing and
18 intermediate care for facilities identified in clauses (2) and
19 (3) after June 30, 1993, the department will recognize as
20 allowable costs depreciation costs for existing, new, renovated
21 or purchased facilities and interest costs on capital
22 indebtedness on debt service incurred to finance a maximum cost
23 per bed of forty-one thousand dollars ($41,000) for the fiscal
24 year ending June 30, 1994. Thereafter, the forty-one thousand
25 dollar ($41,000) per bed limit shall be adjusted annually to
26 account for inflation using an index which reflects the changes
27 in construction costs for such facilities. Nothing herein is
28 intended to require the department to recognize depreciation and
29 interest costs for facilities which the department would not
30 otherwise recognize except to the extent that the current
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1 twenty-two thousand dollar ($22,000) per bed limit shall be
2 increased as provided herein.
3 Section 2. This act shall take effect immediately.
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