GAB Decision 754
May 19, 1986
Pennsylvania Depaerment of Public Welfare;
Docket No. 86-69
Ford, Cecilia S.; Garrett, Donald F.
The Pennsylvania Department of Public Welfare (State) appealed a
decision by the Health Care Financing Administration (Agency)
disallowing $3,635,705 in federal financial participation claimed by the
State under Title XIX of the Social Security Act. The claim was for the
quarter ending June 30, 1985, and involves inpatient psychiatric
services rendered to individuals between the ages of 22 and 64 during
the months they were admitted to or discharged from institutions for
mental diseases.
In its notice of appeal, the State indicated that the issues in
this
appeal are identical to those decided by the Board in
Joint
Consideration: IMD Admission/Discharge Issue, Decision No. 436,
May 31,
1983. Although a new regulation, 42 CFR 436.1004, appearing at
50 Fed.
Reg. 13196 (April 3, 1985), became effective May 3, 1985, the
Agency
stated that this appeal did not include any claims for periods after
the
effective date of the new regulation. The Agency agreed with the
State
that separate proceedings in this case were unnecessary and that
the
Board could proceed to decision based on the parties' presentations
in
the cases leading to Decision No. 436. Accordingly, for the
reasons
stated in Decision No. 436, which is incorporated here by reference,
we
uphold this $3,635,705 disallowance, subject to reduction under the
same
conditions as the disallowances in Decision No. 436.