Minnesota Legislature
SF 697
as introduced - 86th Legislature (2009 - 2010) Posted on 02/09/2010 02:15am
Current Version - as introduced
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A bill for an act
relating to human services; providing long-term care provider rate adjustments;
modifying the phase-in of rebased nursing facility rates; providing funding for
nursing facility moratorium exceptions and extending project approval; requiring
the commissioner of human services to develop recommendations on specialized
care; amending Minnesota Statutes 2008, sections 144A.073, by adding a
subdivision; 256B.441, subdivisions 31, 51a, 55, by adding a subdivision.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2008, section 144A.073, is amended by adding a
subdivision to read:
new text begin Subd. 12. new text end
new text begin
Extension of approval of moratorium exception projects.
new text end
new text begin
Notwithstanding subdivision 3, the commissioner of health shall extend project approval
by an additional 18 months for an approved proposal for an exception to the nursing home
licensure and certification moratorium if the proposal was approved under this section
between July 1, 2007, and June 30, 2009.
new text end
Sec. 2.
Minnesota Statutes 2008, section 256B.441, subdivision 31, is amended to read:
Subd. 31.
Prior deleted text begin systemdeleted text end new text begin yearnew text end operating cost payment rate.
"Prior deleted text begin systemdeleted text end new text begin yearnew text end
operating cost payment rate" means the operating cost payment rate in effect on September
30deleted text begin , 2008,deleted text end new text begin prior to the start of each rate year new text end under Minnesota Rules and Minnesota
Statutes, not including planned closure rate adjustments under section 256B.436 or
256B.437, deleted text begin ordeleted text end single bed room incentives under section 256B.431, subdivision 42new text begin , or
performance-based incentive payments under section 256B.434, subdivision 4, paragraph
(d). The rate shall include the temporary rate adjustment provided to nursing facilities in
Laws 2008, chapter 363, article 18, section 3, subdivision 6, paragraph (c)new text end .
Sec. 3.
Minnesota Statutes 2008, section 256B.441, subdivision 51a, is amended to
read:
Subd. 51a.
Exception allowing contracting for specialized care.
(a) For rate years
beginning on or after October 1, 2016, the commissioner may negotiate increases to
the care-related limit for nursing facilities that provide specialized care, at a cost to the
general fund not to exceed $600,000 per year. The commissioner shall publish a request
for proposals annually, and may negotiate increases to the limits that shall apply for either
one or two years before the increase shall be subject to a new proposal and negotiation.
The care-related limit may be increased by up to 50 percent.
(b) In selecting facilities with which to negotiate, the commissioner shall consider:
(1) the diagnoses or other circumstances of residents in the specialized program that
require care that costs substantially more than the RUG's rates associated with those
residents;
(2) the nature of the specialized program or programs offered to meet the needs
of these individuals; and
(3) outcomes achieved by the specialized program.
new text begin
(c) The commissioner, in consultation with stakeholders, shall develop
recommendations on which facilities and residents should qualify for specialized care
under this subdivision, and how rate adjustments for specialized care should be determined.
The commissioner shall report the recommendations to the legislature by January 1, 2010.
new text end
Sec. 4.
Minnesota Statutes 2008, section 256B.441, subdivision 55, is amended to read:
Subd. 55.
Phase-in of rebased operating payment rates.
(a) For the rate years
beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated
under this section shall be phased in by blending the operating rate with the deleted text begin operating
payment rate determined under section 256B.434deleted text end new text begin prior year operating cost payment
ratenew text end . deleted text begin For purposes of this subdivision, the rate to be used that is determined under
section 256B.434 shall not include the portion of the operating payment rate related to
performance-based incentive payments under section 256B.434, subdivision 4, paragraph
(d).deleted text end For the rate year beginning October 1, 2008, the operating payment rate for each
facility shall be 13 percent of the operating payment rate from this section, and 87 percent
of the operating payment rate from section 256B.434. For the rate year beginning October
1, 2009, the operating payment rate for each facility shall be deleted text begin 14deleted text end new text begin 25.5new text end percent of the
operating payment rate from this section, and deleted text begin 86deleted text end new text begin 74.5new text end percent of thenew text begin prior yearnew text end operatingnew text begin
costnew text end payment rate deleted text begin from section 256B.434deleted text end . For the rate year beginning October 1, 2010, the
operating payment rate for each facility shall be deleted text begin 14deleted text end new text begin 38new text end percent of the operating payment
rate from this section, and deleted text begin 86deleted text end new text begin 62new text end percent of thenew text begin prior yearnew text end operatingnew text begin costnew text end payment rate deleted text begin from
section 256B.434deleted text end . For the rate year beginning October 1, 2011, the operating payment
rate for each facility shall be deleted text begin 31deleted text end new text begin 50.5new text end percent of the operating payment rate from this
section, and deleted text begin 69deleted text end new text begin 49.5new text end percent of thenew text begin prior yearnew text end operatingnew text begin costnew text end payment rate deleted text begin from section
256B.434deleted text end . For the rate year beginning October 1, 2012, the operating payment rate for
each facility shall be deleted text begin 48deleted text end new text begin 63new text end percent of the operating payment rate from this section, and
deleted text begin 52deleted text end new text begin 37new text end percent of thenew text begin prior yearnew text end operatingnew text begin costnew text end payment rate deleted text begin from section 256B.434deleted text end . For
the rate year beginning October 1, 2013, the operating payment rate for each facility shall
be deleted text begin 65deleted text end new text begin 75.5new text end percent of the operating payment rate from this section, and deleted text begin 35deleted text end new text begin 24.5new text end percent
of thenew text begin prior yearnew text end operatingnew text begin costnew text end payment rate deleted text begin from section 256B.434deleted text end . For the rate year
beginning October 1, 2014, the operating payment rate for each facility shall be deleted text begin 82deleted text end new text begin 88new text end
percent of the operating payment rate from this section, and deleted text begin 18deleted text end new text begin 12new text end percent of thenew text begin prior yearnew text end
operatingnew text begin costnew text end payment rate deleted text begin from section 256B.434deleted text end . For the rate year beginning October
1, 2015, the operating payment rate for each facility shall be the operating payment rate
determined under this section. The blending of operating payment rates under this section
shall be performed separately for each RUG's class.
(b) For the rate year beginning October 1, 2008, the commissioner shall apply limits
to the operating payment rate increases under paragraph (a) by creating a minimum
percentage increase and a maximum percentage increase.
(1) Each nursing facility that receives a blended October 1, 2008, operating payment
rate increase under paragraph (a) of less than one percent, when compared to its operating
payment rate on September 30, 2008, computed using rates with RUG's weight of 1.00,
shall receive a rate adjustment of one percent.
(2) The commissioner shall determine a maximum percentage increase that will
result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing
facilities with a blended October 1, 2008, operating payment rate increase under paragraph
(a) greater than the maximum percentage increase determined by the commissioner, when
compared to its operating payment rate on September 30, 2008, computed using rates with
a RUG's weight of 1.00, shall receive the maximum percentage increase.
(3) Nursing facilities with a blended October 1, 2008, operating payment rate
increase under paragraph (a) greater than one percent and less than the maximum
percentage increase determined by the commissioner, when compared to its operating
payment rate on September 30, 2008, computed using rates with a RUG's weight of 1.00,
shall receive the blended October 1, 2008, operating payment rate increase determined
under paragraph (a).
(4) The October 1, 2009, through October 1, 2015, operating payment rate for
facilities receiving the maximum percentage increase determined in clause (2) shall be
the amount determined under paragraph (a) less the difference between the amount
determined under paragraph (a) for October 1, 2008, and the amount allowed under clause
(2). This rate restriction does not apply to rate increases provided in any other section.
(c) A portion of the funds received under this subdivision that are in excess of
operating payment rates that a facility would have received under section 256B.434, as
determined in accordance with clauses (1) to (3), shall be subject to the requirements in
section 256B.434, subdivision 19, paragraphs (b) to (h).
(1) Determine the amount of additional funding available to a facility, which shall be
equal to total medical assistance resident days from the most recent reporting year times
the difference between the blended rate determined in paragraph (a) for the rate year being
computed and the blended rate for the prior year.
(2) Determine the portion of all operating costs, for the most recent reporting year,
that are compensation related. If this value exceeds 75 percent, use 75 percent.
(3) Subtract the amount determined in clause (2) from 75 percent.
(4) The portion of the fund received under this subdivision that shall be subject to
the requirements in section 256B.434, subdivision 19, paragraphs (b) to (h), shall equal
the amount determined in clause (1) times the amount determined in clause (3).
Sec. 5.
Minnesota Statutes 2008, section 256B.441, is amended by adding a
subdivision to read:
new text begin Subd. 59. new text end
new text begin Rate adjustments for October 1, 2009, and October 1, 2010. new text end
new text begin
For the
rate years beginning October 1, 2009, and October 1, 2010, the commissioner shall make
available to each nursing facility reimbursed under this section operating payment rate
adjustments equal to the change in the Nursing Home with Capital Market Basket as
calculated by Global Insight from the midpoint of the previous rate year to the midpoint
of the next rate year. This increase shall be applied to operating rates after the rebasing
adjustment provided under subdivision 55.
new text end
Sec. 6. new text begin RATE ADJUSTMENTS FOR ELDERLY WAIVER AND ALTERNATIVE
CARE PROGRAMS.
new text end
new text begin
For the rate years beginning July 1, 2009, and July 1, 2010, the commissioner of
human services shall provide rate adjustments for the elderly waiver and alternative care
programs that are equal to the change in the Nursing Home with Capital Market Basket as
calculated by Global Insight from the midpoint of the previous nursing home rate year to
the midpoint of the next nursing home rate year. Managed care organization payment rates
to providers under the elderly waiver program must reflect these rate adjustments as of
the date the adjustments are effective under this section.
new text end
Sec. 7. new text begin NURSING HOME MORATORIUM EXCEPTIONS.
new text end
new text begin
During fiscal year 2010, the commissioner of health may approve moratorium
exception projects under Minnesota Statutes, section 144A.073, for which the full
annualized state share of medical assistance costs does not exceed $3,000,000. During
fiscal year 2011, the commissioner of health may approve moratorium exception projects
under Minnesota Statutes, section 144A.073, for which the full annualized state share of
medical assistance costs does not exceed $3,000,000 less the amount approved during
the first year.
new text end