Review of Pennsylvania’s Determination of Medicaid Disproportionate Share Hospital Eligibility for the State-Operated Institutions for Mental Diseases (A-03-08-00203)

April 1, 2009 This report found that the Pennsylvania Department of Public Welfare (DPW) did not fully comply with its state plan and federal requirements in determining whether state-operated institutions of mental disease were eligible for Medicaid payments in fiscal year 2008-2009. DPW included some patient days related to unallowable age groups and inmates held in institutions by the state's criminal justice system. Institutions for Mental Diseases (IMD) may be eligible for DSH payments to recoup the unreimbursed costs of providing inpatient care to patients who are either Medicaid eligible or uninsured. Section 1923(d)(3) of . . .