An Act amending the act of June 13, 1967 (P.L.31, No.21), known as the Human Services Code, in public assistance, further providing for medical assistance payments for institutional care.

PRINTER'S NO. 1432
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 1310
Session of
2025
INTRODUCED BY BIZZARRO, MADDEN, GIRAL, KHAN, GUENST, PROBST,
SANCHEZ, MALAGARI, KENYATTA, DONAHUE, GREEN, CEPEDA-FREYTIZ,
CERRATO, GREINER AND KUTZ, APRIL 21, 2025
REFERRED TO COMMITTEE ON AGING AND OLDER ADULT SERVICES,
APRIL 21, 2025
AN ACT
Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
act to consolidate, editorially revise, and codify the public
welfare laws of the Commonwealth," in public assistance,
further providing for medical assistance payments for
institutional care.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 443.1(7)(iv) of the act of June 13, 1967
(P.L.31, No.21), known as the Human Services Code, is amended to
read:
Section 443.1. Medical Assistance Payments for Institutional
Care.--The following medical assistance payments shall be made
on behalf of eligible persons whose institutional care is
prescribed by physicians:
* * *
(7) After June 30, 2007, payments to county and nonpublic
nursing facilities enrolled in the medical assistance program as
providers of nursing facility services shall be determined in
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accordance with the methodologies for establishing payment rates
for county and nonpublic nursing facilities specified in the
department's regulations and the Commonwealth's approved Title
XIX State Plan for nursing facility services in effect after
June 30, 2007. The following shall apply:
* * *
(iv) Subject to Federal approval of such amendments as may
be necessary to the Commonwealth's approved Title XIX State
Plan, for each fiscal year beginning on or after July 1, 2011,
the department shall apply a revenue adjustment neutrality
factor to county and nonpublic nursing facility payment rates so
that the estimated Statewide day-weighted average payment rate
in effect for that fiscal year is limited to the amount
permitted by the funds appropriated by the General Appropriation
Act for the fiscal year. The revenue adjustment neutrality
factor shall remain in effect until the sooner of June 30, 2022,
or the date on which a new rate-setting methodology for medical
assistance nursing facility services which replaces the rate-
setting methodology codified in 55 Pa. Code Chs. 1187 (relating
to nursing facility services) and 1189 (relating to county
nursing facility services) takes effect[.] as follows:
(A) For each fiscal year, beginning on or after July 1,
2025, the revenue adjustment neutrality factor applied to
nonpublic nursing facility rates shall be equal to or greater
than 0.90.
(B) For each fiscal year, beginning on or after July 1,
2025, the revenue adjustment neutrality factor applied to county
nursing facility rates shall equal 1.00 plus the percentage rate
of change used in determining the revenue adjustment factor
applied to nonpublic nursing facility rates in clause (A).
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* * *
Section 2. This act shall take effect in 60 days.
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