2013 Session

Budget Amendments - SB800 (Member Request)

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Chief Patron: McEachin
Eliminate Occupancy Standard for Medicaid Nursing Home Reimbursement

Item 307 #4s

Item 307 #4s

First Year - FY2013 Second Year - FY2014
Health And Human Resources
Medical Assistance Services, Department of FY2013 $0 FY2014 $2,900,000 GF
FY2013 $0 FY2014 $2,900,000 NGF

Page 263, line 15, strike "$8,033,837,513" and insert "$8,039,637,513".
Page 280, after line 14, insert:
"JJJJ.  The Department of Medicaid Assistance Services shall amend the State Plan for Medical Assistance to increase the reimbursement rates in the current nursing facility operating payment system to eliminate the occupancy standard of 90 percent for indirect and plant costs, effective July 1, 2013. The department shall have the authority to implement this reimbursement change effective July 1, 2013, and prior to the completion of any regulatory process undertaken in order to effect such change."

(This amendment adds $2.9 million from the general fund and $2.9 million in matching federal Medicaid funds the second year to eliminate the 90 percent occupancy standard used in calculating nursing home reimbursement rates for indirect care and plant costs. This standard was originally used to adjust nursing home payments to ensure that reimbursements rewarded more cost efficient nursing facilities. The Governor's proposed budget reduces the occupancy rate from 90 percent to 88 percent, recognizing the impact that increased home- and community-based services has had on lowering occupancy rates in nursing facilities and the fact that those remaining in nursing homes have higher acuity levels and consequently higher costs. Currently, about 38 percent of nursing facilities have capacities below 90 percent (98 of 258 facilities). This amendment completely eliminates the standard.)