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 facilitiesthat have entered into an alternative payment1.13demonstration contract under this sectionas 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 admissionis an amount equal to the greater of1.20the Medicare payment rate for that facility or the resident's1.21medical assistance case mix payment rate. For the first year of1.22an alternative payment demonstration project contract the1.23commissioner shall establish a maximum private paying rate for1.24short-stay residents that is based on a nursing facility's1.25estimated Medicare payment rate. When actual Medicare final2.1rates are determined, the nursing facility shall retroactively2.2adjust a private paying resident's rates and provide a refund or2.3credit if the amount actually paid by the resident exceeds the2.4amount that would have been paid using Medicare ratesshall 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 maximumspecifiedallowed 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 ratespecifiedallowed 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 2.27a demonstration project contractJuly 1, 1997.