This transmittal is being submitted to amend 1915(j) eligibility criteria.

Additional Class of Disproportionate Share Payments to Critical Access Hospitals and Qualifying Rural Hospitals.

Phase-out the use of the allowable MA costs incurred by county nursing facilities in calculating rates for MA non-public nursing facilities over a three year rate period beginning July 1, 2009, and ending June 30, 2012. Phase-in minimum occupancy requirements for MA non-public and county nursing facilities to receive reserved bed day payments for MA. Extend the provisions related to computing per diem rates for county nursing facilities that privatize through FY 2009-20I2.

Pass-through payments to MA nursing facilites to recognize the MA portion of the health care-associated infection (HAl) surcharge levied by the Pennsylvania Department of Health.

Methods and standards for reasonable cost-related reimbursement for state operated nursing facilities.

Budget Adjustment Factor for County Nursing Facilities. for Rate Year 2009-2010 and extension of the BAF for rate years 2009-2010 and 2010-2011.

Extension of Medicaid Day One Incentive payments (MDOI) and funding levels for fiscal years (FYs) 2009-2010 and 2010-2011.Extension of Pay For Performance Incentive payments (P4P) to qualifying county nursing facilities for FYs 2009-2010, 2010-2011 and 2011-2012.

This amendment amends the current aggregate limits Pennsylvania uses to determine disproportionate share adjustment (DSH) payments for Inpatient DSH, Outpatient DSH and Direct Medical Education to qualifying hospitals.

To establish a greater Personal Needs Allowance under Post-Eligibility Treatment oflncome oflndividuals Residing in State Veterans Homes.

Additional class of Disproportionate Share to Qualifying Teaching Hospitals.