Citations Affected: Noncode.
Synopsis: Nursing facility quality assessment fee. Extends collection
of the nursing facility quality assessment until August 1, 2009.
Effective: July 1, 2007.
January 8, 2007, read first time and referred to Committee on Health and Provider
Services.
January 18, 2007, amended, reported favorably _ Do Pass.
January 25, 2007, read second time, amended, ordered engrossed.
A BILL FOR AN ACT concerning Medicaid.
Medicaid revenue, adjusted annually by the average annual
percentage increase in Medicaid rates.
(f) If the United States Centers for Medicare and Medicaid Services
determines not to approve payments under this SECTION using the
methodology described in subsection (e), the office shall revise the
state plan amendment and waiver request submitted under subsection
(l) as soon as possible to demonstrate compliance with 42 CFR
433.68(e)(2)(ii). The revised state plan amendment and waiver request
must provide for the following:
(1) Effective August 1, 2003, collection of a quality assessment
by the office from each nursing facility.
(2) Effective August 1, 2003, collection of a quality assessment
by the department of state revenue from each health facility that
is not a nursing facility.
(3) An exemption from collection of a quality assessment from
the following:
(A) A continuing care retirement community.
(B) A health facility that only receives revenue from Medicare
services provided under 42 U.S.C. 1395 et seq.
(C) A health facility that has less than seven hundred fifty
thousand dollars ($750,000) in total annual revenue, adjusted
annually by the average annual percentage increase in
Medicaid rates.
(D) The Indiana Veterans' Home.
Any revision to the state plan amendment or waiver request under this
subsection is subject to and must comply with the provisions of this
SECTION.
(g) If the United States Centers for Medicare and Medicaid Services
determines not to approve payments under this SECTION using the
methodology described in subsections (e) and (f), the office shall revise
the state plan amendment and waiver request submitted under
subsection (l) as soon as possible to demonstrate compliance with 42
CFR 433.68(e)(2)(ii) and to provide for collection of a quality
assessment from health facilities effective August 1, 2003. In amending
the state plan amendment and waiver request under this subsection, the
office may modify the parameters described in subsection (f)(3).
However, if the office determines a need to modify the parameters
described in subsection (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.
facilities unless the select joint commission on Medicaid oversight
recommends the reimbursement change.
(o) A nursing facility or a health facility may not charge the facility's
residents for the amount of the quality assessment that the 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) An action taken under subsection (s)(2) is governed by:
(1) IC 4-21.5-3-8; or
(2) IC 4-21.5-4.
(u) The office shall report the following information to the select
joint commission on Medicaid oversight established by IC 2-5-26-3 at
every meeting of the commission:
(1) Before the quality assessment is approved by the United States
Centers for Medicare and Medicaid Services:
(A) an update on the progress in receiving approval for the
quality assessment; and
(B) a summary of any discussions with the United States
Centers for Medicare and Medicaid Services.