as introduced - 87th Legislature (2011 - 2012) Posted on 03/07/2012 02:16pm
A bill for an act
relating to human services; modifying nursing facility Medicare certification;
amending Minnesota Statutes 2010, sections 256B.434, subdivision 10; 256B.48,
by adding a subdivision; repealing Minnesota Statutes 2010, section 256B.48,
subdivision 6.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Minnesota Statutes 2010, section 256B.434, subdivision 10, is amended to
read:
(a) To the extent permitted by federal law, (1) a facility that
has entered into a contract under this section is not required to file a cost report, as defined
in Minnesota Rules, part 9549.0020, subpart 13, for any year after the base year that is the
basis for the calculation of the contract payment rate for the first rate year of the alternative
payment demonstration project contract; and (2) a facility under contract is not subject
to audits of historical costs or revenues, or paybacks or retroactive adjustments based on
these costs or revenues, except audits, paybacks, or adjustments relating to the cost report
that is the basis for calculation of the first rate year under the contract.
(b) A facility that is under contract with the commissioner under this section is
not subject to the moratorium on licensure or certification of new nursing home beds in
section 144A.071, unless the project results in a net increase in bed capacity or involves
relocation of beds from one site to another. Contract payment rates must not be adjusted
to reflect any additional costs that a nursing facility incurs as a result of a construction
project undertaken under this paragraph. In addition, as a condition of entering into a
contract under this section, a nursing facility must agree that any future medical assistance
payments for nursing facility services will not reflect any additional costs attributable to
the sale of a nursing facility under this section and to construction undertaken under
this paragraph that otherwise would not be authorized under the moratorium in section
144A.073. Nothing in this section prevents a nursing facility participating in the
alternative payment demonstration project under this section from seeking approval of
an exception to the moratorium through the process established in section 144A.073,
and if approved the facility's rates shall be adjusted to reflect the cost of the project.
Nothing in this section prevents a nursing facility participating in the alternative payment
demonstration project from seeking legislative approval of an exception to the moratorium
under section 144A.071, and, if enacted, the facility's rates shall be adjusted to reflect the
cost of the project.
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(c) Notwithstanding section 256B.48, subdivision 6, paragraphs (c), (d), and (e),
and pursuant to any terms and conditions contained in the facility's contract, a nursing
facility that is under contract with the commissioner under this section is in compliance
with section 256B.48, subdivision 6, paragraph (b), if the facility is Medicare certified.
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deleted text begin (d)deleted text end new text begin (c) new text end Notwithstanding paragraph (a), if by April 1, 1996, the health care financing
administration has not approved a required waiver, or the Centers for Medicare and
Medicaid Services otherwise requires cost reports to be filed prior to the waiver's approval,
the commissioner shall require a cost report for the rate year.
deleted text begin (e)deleted text end new text begin (d)new text end A facility that is under contract with the commissioner under this section
shall be allowed to change therapy arrangements from an unrelated vendor to a related
vendor during the term of the contract. The commissioner may develop reasonable
requirements designed to prevent an increase in therapy utilization for residents enrolled
in the medical assistance program.
deleted text begin (f)deleted text end new text begin (e)new text end Nursing facilities participating in the alternative payment system
demonstration project must either participate in the alternative payment system quality
improvement program established by the commissioner or submit information on their
own quality improvement process to the commissioner for approval. Nursing facilities
that have had their own quality improvement process approved by the commissioner
must report results for at least one key area of quality improvement annually to the
commissioner.
Minnesota Statutes 2010, section 256B.48, is amended by adding a subdivision
to read:
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Notwithstanding subdivision
1, nursing facility providers that do not participate in or accept Medicare assignment
must refer and document the referral of dual eligible recipients for whom placement is
requested and for whom the resident would be qualified for a Medicare-covered stay to
Medicare providers. The commissioner shall audit nursing facilities that do not accept
Medicare and determine if dual eligible individuals with Medicare qualifying stays have
been admitted. If such a determination is made, the commissioner shall deny Medicaid
payment for the first 20 days of that resident's stay.
new text end
new text begin
Minnesota Statutes 2010, section 256B.48, subdivision 6,
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new text begin
is repealed.
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