E Modifying or clarifying certain provisions relating to long term care; clarifying certain prohibitions on duplicate services and expanding a certain provision providing criteria for direct cash payments under the medical assistance (MA) alternative care program; eliminating and repealing certain obsolete provisions providing for determination by the commissioner of human services of medical assistance payment rates for nursing facilities and providing for the effect of pending legislation on establishment of the rates; eliminating the requirement for the commissioner to increase the care related operating rate to reimburse facilities for unfunded federal mandates (ra, ja)