Current through Register Vol. 54, No. 44, November 2, 2024
(a) Inpatient psychiatric facilities which
place a new capital project into service after the base year, as determined
under §
1151.46 (relating to payment rate
calculations for Fiscal Years 1993-94 and 1994-95), are entitled to payment for
certain capital costs, if the qualifying criteria, outlined under this section,
are met.
(b) This additional
payment applies only to capital projects with an approval date of either a
Certificate of Need or letter of nonreviewability on or before June 30,
1991.
(c) To apply for an
additional capital payment, an inpatient psychiatric facility shall submit
documentation sufficient to enable the Department to verify that the
requirements of this section are met.
(d) To be eligible for an additional capital
payment, the costs related to a capital project shall meet the following
criteria:
(1) The costs shall represent
increases in the inpatient psychiatric facility's allowable depreciation and
interest costs for a fixed asset that was entered in the inpatient psychiatric
facility's fixed asset ledger in the year being audited.
(2) The costs shall be attributable to a
fixed asset that is both of the following:
(i) Approved for Certificate of Need on or
before June 30, 1991, under 28 Pa. Code Chapter 301 or 401 (relating to
limitations on Federal participation for capital expenditures; and Certificate
of Need Program), or not subject to review for Certificate of Need as evidenced
by a letter of nonreviewability dated on or before June 30, 1991.
(ii) Related to patient care in accordance
with Medicare standards.
(e) For an inpatient psychiatric facility to
qualify for an additional capital payment set forth in this section, the
following criteria shall be met:
(1) The
inpatient psychiatric facility's rate of increase in overall audited costs
shall exceed 15%. The Department will establish this rate of increase by
comparing the inpatient psychiatric facility's audited costs for the fiscal
year to its audited costs for the preceding fiscal year.
(2) The inpatient psychiatric facility's rate
of increase for allowable depreciation and interest shall exceed its rate of
increase for net operating costs. The Department will determine the rate of
increase in an inpatient psychiatric facility's net operating cost by comparing
the inpatient psychiatric facility's audited net operating costs for the fiscal
year to its audited net operating costs for the preceding fiscal year. The
Department will determine the rate of increase in an inpatient psychiatric
facility's depreciation and interest costs by:
(i) Determining the inpatient psychiatric
facility's allowable audited depreciation and interest costs for the preceding
fiscal year, including costs excluded in the preceding fiscal year under
subsection (b).
(ii) Adding the
amount allowable under subsection (b) for the fiscal year being audited to the
amount determined under subparagraph (i).
(iii) Comparing the amounts determined under
subparagraphs (i) and (ii) to determine the rate of increase.
(f) For Fiscal Years
1993-94 and 1994-95, for each inpatient psychiatric facility which requests an
additional capital payment, the Department will audit its MA Cost Reports for
the fiscal year for which the request is made, the prior fiscal year and
subsequent fiscal years for which additional capital payment is requested. To
the extent that the facility is determined eligible to receive an additional
capital payment under this section, the following applies:
(1) For each fiscal year the Department will
compare the total MA payments for inpatient psychiatric services paid to the
inpatient psychiatric facility for that fiscal year (the "total payment") with
the inpatient psychiatric facility's actual MA costs for inpatient psychiatric
services as determined at audit, including the allowable capital costs eligible
under this section (the "actual costs").
(2) If the amount of actual costs exceeds the
total payment, the Department will pay the inpatient psychiatric facility the
difference between the actual costs and the total payment, not to exceed the
amount of allowable capital costs.
(3) If the amount of actual costs does not
exceed the total payment, the Department will not pay the inpatient psychiatric
facility any additional capital payment.
(4) The Department will not recoup or offset
any additional capital payment made under this section.
This section cited in 55 Pa. Code §
1151.46 (relating to payment rate
calculations for Fiscal Years 1993-94 and
1994-95).
