Relates to rates of payment for residential health care facilities

1 Co-sponsor

• Darrel J. Aubertine

Title of bill

An act to amend the public health law, in relation to rates of payment for residential health care facilities

Purpose or general idea of bill

The purpose is to continue to provide, for the period January 1, 2009 through March 31, 2009, a rate adjustment to Medicaid nursing home rates to phase-in reimbursement to a rate setting methodology based on 2002 costs and effective April 1, 2009.

Summary of specific provisions

This legislation provides that Medicaid nursing home rates for the period January 1, 2009 through March 31, 2009 shall be the rates in effect December 31, 2006 adjusted by a per diem add-on to reflect a nursing home's proportional amount of the total projected Medicaid benefit of a new rate setting methodology based on 2002 costs and effective April 1, 2009 with a cap on the aggregate total of such rate adjustments. Other changes made to the law are technical corrections to dates.

Existing law

The February 2009 Deficit Reduction Plan delayed from January 1,2009 to April 1, 2009, implementation of the new nursing home rate setting methodology, and inadvertently did not continue phase-in funding.

Justification

The February 2009 Deficit Reduction Plan which was enacted into law delayed implementation of the new rate setting methodology based on 2002 costs from January 1, 2009 to April 1, 2009, but neglected to continue the phase-in funding. This legislation simply continues for the period January 1, 2009 to March 31, 2009, the phase-in funding amount that was in effect on December 31, 2008, and limits the aggregate total of the rate adjustments.

Without this legislation, Medicaid nursing home rates for the period January 1, 2009 through March 31, 2009 will be reduced to the amounts in effect on December 31, 2006 instead of being continued at the amounts in effect on December 31, 2008. This would mean that not only would nursing homes not have the financial benefit that moving to a 2002 base year was intended to provide, but the nursing homes would also have an actual reduction in reimbursement. Such a result was not what the legislature intended and is clearly unfair to providers.

In 2006, legislation was enacted into law to provide for a new nursing home rate setting methodology and to be fully effective January 1, 2009. The law provided that the methodology would be phased in during 2007 and 2008 through phase-in adjustments. This rate setting methodology was the result of several years of study and analysis and was agreed to by the Legislature and the Governor.

Prior legislative history

None.

Fiscal implications

EFFECTIVE DATE : This act shall take effect immediately.