<a id="pl.1.3"></a><var>1.3</var>nursing facilities; requiring a local share of nonfederal medical assistance costs;<br/>
<a id="pl.1.4"></a><var>1.4</var>amending Minnesota Statutes 2008, sections 256B.19, by adding a subdivision; <br/>
<a id="pl.1.5"></a><var>1.5</var>256B.441, by adding a subdivision.<br/>
<a id="pl.1.6"></a><var>1.6</var>BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:<br/>
<br/>
<a id="bill.0.1.0"></a><a id="pl.1.7"></a><var>1.7</var>    Section 1. Minnesota Statutes 2008, section 256B.19, is amended by adding a <br/>
<a id="pl.1.8"></a><var>1.8</var>subdivision to read:<br/>
<a id="pl.1.9"></a><var>1.9</var>    Subd. 1e. <b>Additional local share of certain nursing facility costs.</b> Beginning <br/>
<a id="pl.1.10"></a><var>1.10</var>January 1, 2011, local government entities that own the physical plant or are the license <br/>
<a id="pl.1.11"></a><var>1.11</var>holder of nursing facilities receiving rate adjustments under section 256B.441, subdivision <br/>
<a id="pl.1.12"></a><var>1.12</var>55a, shall be responsible for paying the portion of nonfederal costs calculated under <br/>
<a id="pl.1.13"></a><var>1.13</var>section 256B.441, subdivision 55a, paragraph (d). Payments of the nonfederal share <br/>
<a id="pl.1.14"></a><var>1.14</var>shall be made monthly to the commissioner in amounts determined in accordance with <br/>
<a id="pl.1.15"></a><var>1.15</var>section 256B.441, subdivision 55a, paragraph (d). Payments for each month beginning <br/>
<a id="pl.1.16"></a><var>1.16</var>in January 2011 through September 2015 shall be due by the 15th day of the following <br/>
<a id="pl.1.17"></a><var>1.17</var>month. If any provider obligated to pay an amount under this subdivision is more than two <br/>
<a id="pl.1.18"></a><var>1.18</var>months delinquent in the timely payment of the monthly installment, the commissioner <br/>
<a id="pl.1.19"></a><var>1.19</var>may withhold payments, penalties, and interest in accordance with the methods outlined in <br/>
<a id="pl.1.20"></a><var>1.20</var>section 256.9657, subdivision 7a.<br/>
<br/>
<a id="bill.0.2.0"></a><a id="pl.1.21"></a><var>1.21</var>    Sec. 2. Minnesota Statutes 2008, section 256B.441, is amended by adding a <br/>
<a id="pl.1.22"></a><var>1.22</var>subdivision to read:<br/>
<a id="pl.1.23"></a><var>1.23</var>    Subd. 55a. <b>Alternative to phase-in for publicly owned nursing facilities.</b> (a) For <br/>
<a id="pl.1.24"></a><var>1.24</var>operating payment rates implemented between January 1, 2011, and September 30, 2015, <br/>
<a id="pl.2.1"></a><var>2.1</var>the commissioner shall allow nursing facilities whose physical plant is owned or whose <br/>
<a id="pl.2.2"></a><var>2.2</var>license is held by a city, county, or hospital district to apply for a higher payment rate <br/>
<a id="pl.2.3"></a><var>2.3</var>under this section if the local government entity agrees to pay a specified portion of the <br/>
<a id="pl.2.4"></a><var>2.4</var>nonfederal share of medical assistance costs. Nursing facilities that apply shall be eligible <br/>
<a id="pl.2.5"></a><var>2.5</var>for a payment rate up to the rate calculated in subdivision 54, without application of the <br/>
<a id="pl.2.6"></a><var>2.6</var>phase-in under subdivision 55.<br/>
<a id="pl.2.7"></a><var>2.7</var>(b) Rates determined under this subdivision shall take effect beginning January 1, <br/>
<a id="pl.2.8"></a><var>2.8</var>2011, based on cost reports for the rate year ending September 30, 2009, and in future rate <br/>
<a id="pl.2.9"></a><var>2.9</var>years, rates determined for nursing facilities participating under this subdivision shall take <br/>
<a id="pl.2.10"></a><var>2.10</var>effect on October 1 of each year, based on the most recent available cost report.<br/>
<a id="pl.2.11"></a><var>2.11</var>(c) Eligible nursing facilities that wish to participate under this subdivision shall <br/>
<a id="pl.2.12"></a><var>2.12</var>make an application to the commissioner by September 30, 2010. Participation under this <br/>
<a id="pl.2.13"></a><var>2.13</var>subdivision is irrevocable. If paragraph (a) does not result in a rate greater than what <br/>
<a id="pl.2.14"></a><var>2.14</var>would have been provided without application of this subdivision, a facility's rates shall be <br/>
<a id="pl.2.15"></a><var>2.15</var>calculated as otherwise provided and no payment by the local government entity shall <br/>
<a id="pl.2.16"></a><var>2.16</var>be required under paragraph (d).<br/>
<a id="pl.2.17"></a><var>2.17</var>(d) For each participating nursing facility, the public entity that owns the physical <br/>
<a id="pl.2.18"></a><var>2.18</var>plant or is the license holder of the nursing facility shall pay to the state the entire <br/>
<a id="pl.2.19"></a><var>2.19</var>nonfederal share of medical assistance payments received as a result of the difference <br/>
<a id="pl.2.20"></a><var>2.20</var>between the nursing facility's payment rate under subdivision 54 and the rate that the <br/>
<a id="pl.2.21"></a><var>2.21</var>nursing facility would otherwise be paid under subdivision 55 as determined by the <br/>
<a id="pl.2.22"></a><var>2.22</var>commissioner.<br/>
<a id="pl.2.23"></a><var>2.23</var>(e) The commissioner may, at any time, reduce the payments under this subdivision <br/>
<a id="pl.2.24"></a><var>2.24</var>based on the commissioner's determination that the payments shall cause nursing facility <br/>
<a id="pl.2.25"></a><var>2.25</var>rates to exceed the state's Medicare upper payment limit or any other federal limitation. If <br/>
<a id="pl.2.26"></a><var>2.26</var>the commissioner determines a reduction is necessary, the commissioner shall reduce all <br/>
<a id="pl.2.27"></a><var>2.27</var>payment rates for participating nursing facilities by a percentage applied to the amount of <br/>
<a id="pl.2.28"></a><var>2.28</var>increase they would otherwise receive under this subdivision and shall notify participating <br/>
<a id="pl.2.29"></a><var>2.29</var>facilities of the reductions. If payments to a nursing facility are reduced, payments under <br/>
<a id="pl.2.30"></a><var>2.30</var>section 256B.19, subdivision 1e, shall be reduced accordingly.<br/>