2015 Session

Budget Amendments - SB800 (Floor Approved)

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Hold Harmless for Nursing Facilities from Reimbursement System Change

Item 301 #6s

Item 301 #6s

First Year - FY2015 Second Year - FY2016
Health and Human Resources
Department of Medical Assistance Services FY2015 $0 FY2016 $163,005 GF
FY2015 $0 FY2016 $163,005 NGF

Page 257, line 32, strike "$8,515,698,638" and insert "$8,516,024,648".
Page 273, after line 4, insert:
"6. Effective July 1, 2015, the Department of Medical Assistance Services shall amend the State Plan for Medical Assistance to reimburse the price-based operating rate rather than the transition operating rate to any nursing facility whose licensed bed capacity decreased by at least 30 beds after 2011 and whose occupancy increased from less than 70 percent in 2011 to more than 80 percent in 2013.  The department shall have the authority to implement this reimbursement change effective July 1, 2015 and prior to completion of any regulatory process in order to effect such change.

(This amendment provides funding to hold harmless any nursing facility which was negatively impacted by the conversion from a cost-based reimbursement methodology to a price-based reimbursement methodology for Medicaid nursing facility payments because the methodology did not account for recent facility improvements to provide high quality care. The transition rates that would be imposed on such facilities are based on a three-year period, which penalizes facilities which have recently improved care and invested significant funds to improve the facility. Language is added to outline criteria to reimburse facilities in such circumstances at the price-based operating rate instead of the transition operating rate effective July 1, 2015.)