Citations Affected: Noncode.
Synopsis: Medicaid health facility quality assessment. Provides that
if a health facility fails to pay the quality assessment to the department
of state revenue or a nursing facility fails to pay the quality assessment
to the office of Medicaid policy and planning, the state department of
health must notify the facility and revoke the facility's license. Requires
a health facility to pay interest on late payments.
Effective: July 1, 2003 (retroactive).
January 19, 2005, read first time and referred to Committee on Public Health.
January 25, 2005, amended, reported _ Do Pass.
January 31, 2005, read second time, amended, ordered engrossed.
A BILL FOR AN ACT concerning health.
(f)(3), the office shall modify the parameters in order to achieve a
methodology and result as similar as possible to the methodology and
result described in subsection (f). Any revision of the state plan
amendment and waiver request under this subsection is subject to and
must comply with the provisions of this SECTION.
(h) The money collected from the quality assessment may be used
only to pay the state's share of the costs for Medicaid services provided
under Title XIX of the federal Social Security Act (42 U.S.C. 1396 et
seq.) as follows:
(1) Twenty percent (20%) as determined by the office.
(2) Eighty percent (80%) to nursing facilities.
(i) The office may not begin collection of the quality assessment set
under this SECTION before After:
(1) the amendment to the state plan and waiver request
submitted under this SECTION is approved by the United
States Centers for Medicare and Medicaid Services; and
(2) the office calculates and begins paying enhanced
reimbursement rates set forth in this SECTION;
the office and the department of state revenue shall begin the
collection of the quality assessment set under this SECTION.
(j) If federal financial participation becomes unavailable to match
money collected from the quality assessments for the purpose of
enhancing reimbursement to nursing facilities for Medicaid services
provided under Title XIX of the federal Social Security Act (42 U.S.C.
1396 et seq.), the office and department of state revenue shall cease
collection of the quality assessment under the SECTION.
(k) To implement this act, the:
(1) office shall adopt rules under IC 4-22-2; to implement this act.
and
(2) office and department of state revenue shall adopt joint
rules under IC 4-22-2.
(l) Not later than July 1, 2003, the office shall do the following:
(1) Request the United States Department of Health and Human
Services under 42 CFR 433.72 to approve waivers of 42 CFR
433.68(c) and 42 CFR 433.68(d) by demonstrating compliance
with 42 CFR 433.68(e)(2)(ii).
(2) Submit any state Medicaid plan amendments to the United
States Department of Health and Human Services that are
necessary to implement this SECTION.
(m) After approval of the waivers and state Medicaid plan
amendment applied for under subsection (l), the office and the
department of state revenue shall implement this SECTION effective
July 1, 2003.
(n) The select joint commission on Medicaid oversight, established
by IC 2-5-26-3, shall review the implementation of this SECTION. The
office may not make any change to the reimbursement for nursing
facilities unless the select joint commission on Medicaid oversight
recommends the reimbursement change.
(o) A nursing facility may not charge the nursing facility's residents
for the amount of the quality assessment that the nursing facility pays
under this SECTION.
(p) The office may withdraw a state plan amendment under
subsection (e), (f), or (g) only if the office determines that failure to
withdraw the state plan amendment will result in the expenditure of
state funds not funded by the quality assessment.
(q) If a health facility fails to pay the quality assessment under
this SECTION not later than ten (10) days after the date the
payment is due, the health facility shall pay interest on the quality
assessment at the same rate as determined under
IC 12-15-21-3(6)(A).
(r) The following shall be provided to the state department of
health:
(1) The office shall report each nursing facility that fails to
pay the quality assessment under this SECTION not later
than one hundred twenty (120) days after payment of the
quality assessment is due.
(2) The department of state revenue shall report each health
facility that is not a nursing facility that fails to pay the
quality assessment under this SECTION not later than one
hundred twenty (120) days after payment of the quality
assessment is due.
(s) The state department of health shall do the following:
(1) Notify each nursing facility and each health facility
reported under subsection (r) that the nursing facility's or
health facility's license under IC 16-28 will be revoked if the
quality assessment is not paid.
(2) Revoke the nursing facility's or health facility's license
under IC 16-28 if the nursing facility or the health facility
fails to pay the quality assessment.
(t) The procedure governing an action taken under subsection
(s)(2) is governed by:
(1) IC 4-21.5-3-8; or
(2) IC 4-21.5-4.
(q) (u) This SECTION expires August 1, 2005. 2009.