Bill Text: IN HB1478 | 2011 | Regular Session | Amended
Bill Title: Enhanced health facility quality assessment fee.
Spectrum: Partisan Bill (Republican 2-0)
Status: (Engrossed - Dead) 2011-03-29 - First reading: referred to Committee on Appropriations [HB1478 Detail]
Download: Indiana-2011-HB1478-Amended.html
Citations Affected: IC 16-18; IC 16-28.
Synopsis: Enhanced health facility quality assessment fee. Extends the
collection of a nursing facility quality assessment fee until June 30,
2014, with changes to the amount collected and the amount dispersed,
providing the health facilities with 67% of the money and the state with
33% of the money.
Effective: July 1, 2011.
January 20, 2011, read first time and referred to Committee on Public Health.
February 14, 2011, amended, reported _ Do Pass.
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A BILL FOR AN ACT to amend the Indiana Code concerning
Medicaid.
(1) except for purposes of IC 16-28-15, means a building, a structure, an institution, or other place for the reception, accommodation, board, care, or treatment extending beyond a continuous twenty-four (24) hour period in a week of more than four (4) individuals who need or desire such services because of physical or mental illness, infirmity, or impairment; and
(2) for purposes of IC 16-28-15, has the meaning set forth in IC 16-28-15-3.
(b) The term does not include the premises used for the reception,
accommodation, board, care, or treatment in a household or family, for
compensation, of a person related by blood to the head of the
household or family (or to the spouse of the head of the household or
family) within the degree of consanguinity of first cousins.
(c) The term does not include any of the following:
(1) Hotels, motels, or mobile homes when used as such.
(2) Hospitals or mental hospitals, except for that part of a hospital
that provides long term care services and functions as a health
facility, in which case that part of the hospital is licensed under
IC 16-21-2, but in all other respects is subject to IC 16-28.
(3) Hospices that furnish inpatient care and are licensed under
IC 16-25-3.
(4) Institutions operated by the federal government.
(5) Foster family homes or day care centers.
(6) Schools for individuals who are deaf or blind.
(7) Day schools for individuals with mental retardation.
(8) Day care centers.
(9) Children's homes and child placement agencies.
(10) Offices of practitioners of the healing arts.
(11) Any institution in which health care services and private duty
nursing services are provided that is listed and certified by the
Commission for Accreditation of Christian Science Nursing
Organizations/Facilities, Inc.
(12) Industrial clinics providing only emergency medical services
or first aid for employees.
(13) A residential facility (as defined in IC 12-7-2-165).
(14) Maternity homes.
(15) Offices of Christian Science practitioners.
Chapter 15. Health Facility Quality Assessment Fee
Sec. 1. The imposition of a quality assessment fee under this chapter occurs after July 31, 2011.
Sec. 2. As used in this chapter, "continuing care retirement community" means a health care facility that:
(1) provides independent living services and health facility
services in a campus setting with common areas;
(2) holds continuing care agreements with at least twenty-five
percent (25%) of its residents (as defined in IC 23-2-4-1);
(3) uses the money from the agreements described in
subdivision (2) to provide services to the resident before the
resident may be eligible for Medicaid under IC 12-15; and
(4) meets the requirements of IC 23-2-4.
Sec. 3. As used in this chapter, "health facility" refers to a
health facility that is licensed under this article as a comprehensive
care facility.
Sec. 4. As used in this chapter, "nursing facility" means a health
facility that is certified for participation in the federal Medicaid
program under Title XIX of the federal Social Security Act (42
U.S.C. 1396 et seq.).
Sec. 5. As used in this chapter, "office" refers to the office of
Medicaid policy and planning established by IC 12-8-6-1.
Sec. 6. (a) Effective August 1, 2011, the office shall collect a
quality assessment fee from each health facility.
(b) The quality assessment fee must apply to all non-Medicare
patient days of the health facility. The office shall determine the
quality assessment rate per non-Medicare patient day in a manner
that collects the maximum amount permitted by federal law as of
July 1, 2011, based on the latest nursing facility financial reports
and nursing facility quality assessment data collections forms as of
July 28, 2010.
(c) The office shall offset the collection of the assessment fee for
a health facility:
(1) against a Medicaid payment to the health facility;
(2) against a Medicaid payment to another health facility that
is related to the health facility through common ownership or
control; or
(3) in another manner determined by the office.
Sec. 7. The office shall implement the waiver approved by the
United States Centers for Medicare and Medicaid Services under
42 CFR 433.68(e)(2) that provides for the following:
(1) Nonuniform quality assessment fee rates.
(2) An exemption from collection of a quality assessment fee
from the following:
(A) The following continuing care retirement communities:
(i) A continuing care retirement community that was
registered with the securities commissioner as a
continuing care retirement community on January 1,
2007, is not required to meet the definition of a
continuing care retirement community in section 2 of
this chapter.
(ii) A continuing care retirement community that, for the
period January 1, 2007, through June 30, 2009, operated
independent living units, at least twenty-five percent
(25%) of which are provided under contracts that
require the payment of a minimum entrance fee of at
least twenty-five thousand dollars ($25,000).
(iii) An organization registered under IC 23-2-4 before
July 1, 2009, that provides housing in an independent
living unit for a religious order.
(iv) A continuing care retirement community that meets
the definition set forth in section 2 of this chapter.
(B) A hospital based health facility.
(C) The Indiana Veterans' Home.
Any revision to the state plan amendment or waiver request under
this section is subject to and must comply with the provisions of
this chapter.
Sec. 8. (a) The money collected from the quality assessment fee
may be used only as follows:
(1) Sixty-seven percent (67%) to pay the state's share of costs
for Medicaid nursing facility services provided under Title
XIX of the federal Social Security Act (42 U.S.C. 1396 et seq.).
(2) Thirty-three percent (33%) to the state.
(b) The office may establish a method to allow a health facility
to enter into an agreement to pay the quality assessment fee
collected under this chapter under an installment plan.
Sec. 9. If federal financial participation becomes unavailable to
match money collected from the quality assessment fees for the
purpose of enhancing reimbursement to nursing facilities for
Medicaid services provided under Title XIX of the federal Social
Security Act (42 U.S.C. 1396 et seq.), the office shall cease
collection of the quality assessment fee under this chapter.
Sec. 10. The office shall adopt rules under IC 4-22-2 necessary
to implement this chapter.
Sec. 11. (a) If a health facility fails to pay the quality assessment
fee under this chapter not later than ten (10) days after the date the
payment is due, the health facility shall pay interest on the quality
assessment fee at the same rate as determined under
IC 12-15-21-3(6)(A).
(b) The office shall report to the state department each nursing
facility and each health facility that fails to pay the quality
assessment fee under this chapter not later than one hundred
twenty (120) days after payment of the quality assessment fee is
due.
Sec. 12. (a) The state department shall do the following:
(1) Notify each nursing facility and each health facility
reported under section 11 of this chapter that the nursing
facility's license or health facility's license under IC 16-28 will
be revoked if the quality assessment fee is not paid.
(2) Revoke the nursing facility's license or health facility's
license under IC 16-28 if the nursing facility or the health
facility fails to pay the quality assessment fee.
(b) An action taken under subsection (a)(2) is governed by:
(1) IC 4-21.5-3-8; or
(2) IC 4-21.5-4.
Sec. 13. The select joint commission on Medicaid oversight,
established by IC 2-5-26-3, shall review the implementation of this
chapter.
Sec. 14. This chapter expires June 30, 2014.
