GAB Decision 684
August 21, 1985
Pennsylvania Department of Public Welfare;
Ford, Cecilia Sparks; Settle, Norval D. (John) Ballard, Judith A.
Docket No. 85-140
DECISION
The Pennsylvania Department of Public Welfare appealed a decision by the
Health Care Financing Administration (HCFA) disallowing $3,502,492 in
federal financial participation (FFP) claimed by Pennsylvania under
Title XIX of the Social Security Act for the quarters ending June 30 and
September 30, 1984. The claim was for the full per diem rates for
inpatient services provided to individuals aged 22 to 64 during the
months of admission to or discharge from an institution for mental
diseases (IMDs).
The issues raised by this appeal are identical to those previously
raised by Pennsylvania and other states and addressed by this Board in
Joint Consideration: IMD Admission/Discharge Issue, Decision No. 436,
May 31, 1984. Thus, Pennsylvania requested that, rather than following
its usual procedures, the Board simply issue a summary decision based on
Decision No. 436. HCFA agreed that this procedure would be appropriate
here.
Accordingly, for the reasons stated in Decision No. 436, which we
incorporate here, we uphold this disallowance, subject to reduction on
the basis stated in Decision No. 436.
JANUARY 14, 1986