HF 823

as introduced - 80th Legislature (1997 - 1998) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to human services; changing provisions for 
  1.3             private pay rates of short-stays for nursing 
  1.4             facilities; amending Minnesota Statutes 1996, section 
  1.5             256B.434, subdivision 5. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  Minnesota Statutes 1996, section 256B.434, 
  1.8   subdivision 5, is amended to read: 
  1.9      Subd. 5.  [PRIVATE PAY RATES.] (a) Notwithstanding section 
  1.10  256B.48, subdivision 1, paragraph (a), the commissioner shall 
  1.11  determine the maximum private pay case mix payment rates for 
  1.12  nursing facilities that have entered into an alternative payment 
  1.13  demonstration contract under this section as specified in this 
  1.14  subdivision.  Nothing in this section shall limit the exceptions 
  1.15  for private pay rates authorized under section 256B.48, 
  1.16  subdivision 1, paragraph (a). 
  1.17     (b) The maximum private pay rate for short-stay private 
  1.18  paying residents who are discharged from the facility less than 
  1.19  101 days after admission is an amount equal to the greater of 
  1.20  the Medicare payment rate for that facility or the resident's 
  1.21  medical assistance case mix payment rate.  For the first year of 
  1.22  an alternative payment demonstration project contract the 
  1.23  commissioner shall establish a maximum private paying rate for 
  1.24  short-stay residents that is based on a nursing facility's 
  1.25  estimated Medicare payment rate.  When actual Medicare final 
  2.1   rates are determined, the nursing facility shall retroactively 
  2.2   adjust a private paying resident's rates and provide a refund or 
  2.3   credit if the amount actually paid by the resident exceeds the 
  2.4   amount that would have been paid using Medicare rates shall be 
  2.5   determined by each facility. 
  2.6      (c) When a private paying resident is admitted, a nursing 
  2.7   facility shall determine, based on the resident's care plan, 
  2.8   whether the resident is likely to be discharged less than 101 
  2.9   days after admission.  If the resident is likely to be 
  2.10  discharged less than 101 days after admission, the nursing 
  2.11  facility may charge a short-stay private pay rate up to the 
  2.12  maximum specified allowed in paragraph (b).  If the resident 
  2.13  remains in the facility for longer than 100 days, the facility 
  2.14  shall retroactively reduce the resident's payments to the 
  2.15  maximum long-term rate specified in subdivision 4 effective from 
  2.16  the date of admission and shall reimburse the resident for the 
  2.17  overpayment.  At the resident's option, the facility may 
  2.18  reimburse residents for overpayments by providing a refund or a 
  2.19  credit to be applied to future payments, or a combination of 
  2.20  both, subject to the facility's right to offset for past-due 
  2.21  payments.  If the facility determines, based on the care plan, 
  2.22  that the resident is likely to remain in the facility for longer 
  2.23  than 100 days, the facility shall not charge a private pay rate 
  2.24  greater than the maximum rate specified allowed in subdivision 4.
  2.25     (d) The provisions of paragraphs (b) and (c) do not apply 
  2.26  to short-stay residents admitted prior to the effective date of 
  2.27  a demonstration project contract July 1, 1997.