Citations Affected: IC 12-7-2-189.8 ; IC 12-15-14-2.
Synopsis: Target health facility occupancy rates. Establishes target
statewide average occupancy rates for health facilities that receive
Medicaid funding. Allows the office of Medicaid policy and planning
(OMPP) to implement statewide policies to achieve these occupancy
rates. Requires OMPP to report specified information to the select joint
commission on Medicaid oversight.
Effective: July 1, 2003.
January 16, 2003, read first time and referred to Committee on Health and Provider
A BILL FOR AN ACT to amend the Indiana Code concerning
IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2003]: Sec. 189.8. "Target statewide average
occupancy rate", for purposes of
, means the goal for
the percentage of occupied licensed health facility beds in the state.
SECTION 2. IC 12-15-14-2 , AS AMENDED BY P.L.160-2001, SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2003]: Sec. 2. (a) Payment of nursing facility services shall be determined in accordance with 42 U.S.C. 1396a(a)(13)(A) and any other applicable federal statutes or regulations governing such payments.
(b) The office may not require a provider to submit non-Medicaid revenue information in the provider's annual historical financial report. Non-Medicaid revenue information obtained by Medicaid auditors in the course of their audits may not be used for public reporting purposes.
(c) The office may only request complete balance sheet data that
applies directly to the provider's facility. Complete balance sheet data
acquired by the office under this subsection:
(1) is confidential; and
(2) may only be disclosed:
(A) in the aggregate; or
(B) for an individual facility;
if the office removes all non-Medicaid data.
(d) The following target statewide average occupancy rates apply to a health facility that is licensed under IC 16-28 and receives Medicaid payments:
(1) For calendar year 2004, the target statewide average occupancy rate is seventy-five percent (75%).
(2) For calendar year 2005, the target statewide average occupancy rate is eighty-five percent (85%).
(3) After December 31, 2005, the target statewide average occupancy rate is ninety percent (90%).
(e) The office may adopt statewide policies to facilitate achievement of the target statewide average occupancy rate. These policies may include changing the Medicaid reimbursement system.
(f) The office of the secretary shall adopt rules under IC 4-22-2 to implement the reimbursement system required by this section.
SECTION 3. [EFFECTIVE JULY 1, 2003] (a) As used in this SECTION, "office" refers to the office of Medicaid policy and planning established by IC 12-8-6-1.
(b) Beginning in 2004, the office shall report the following to the select joint commission on Medicaid oversight established by IC 2-5-26-3 not later than October 31 of each year:
(1) A summary of any Medicaid program policy that was implemented the preceding calendar year in order to facilitate achievement of the target statewide average occupancy rate described in IC 12-15-14-2, as amended by this act.
(2) The most current statewide average health facility occupancy rates following the implementation of a policy described in subdivision (1).
(3) Any Medicaid program policy change that the office is considering to achieve the target statewide average occupancy rate described in IC 12-15-14-2, as amended by this act.
(c) This SECTION expires December 31, 2006.