Bill Text: PA HB203 | 2009-2010 | Regular Session | Introduced

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Bill Title: Exempting continuing care retirement communities from the medical assistance bed approval process and allowing nursing facilities operated by continuing care retirement communities to obtain medical assistance certified beds under limited terms and conditions.

Spectrum: Moderate Partisan Bill (Republican 6-1)

Status: (Introduced - Dead) 2009-02-02 - Referred to AGING AND OLDER ADULT SERVICES [HB203 Detail]

Download: Pennsylvania-2009-HB203-Introduced.html

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PRINTER'S NO. 202
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 203 Session of2009
INTRODUCED BY GODSHALL, BARRAR, CALTAGIRONE, DENLINGER, PICKETT AND SWANGER, FEBRUARY 2, 2009
REFERRED TO COMMITTEE ON AGING AND OLDER ADULT SERVICES, FEBRUARY 2, 2009
AN ACT
Exempting continuing care retirement communities from the
medical assistance bed approval process and allowing nursing
facilities operated by continuing care retirement communities
to obtain medical assistance certified beds under limited
terms and conditions.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"CCRC." A continuing care retirement community licensed by
the Insurance Department.
"Department." The Department of Public Welfare of the
Commonwealth.
Section 2. Continuing care retirement community exemption.
A licensed nursing facility operated by a licensed CCRC shall
be exempt from the requirements under 55 Pa. Code §§ 1187.21(2)
(relating to nursing facility participation requirements) and
1187.21a (relating to nursing facility exception requests--
statement of policy) under the following conditions:
(1) The CCRC has admitted over 400 residents under a
continuing care agreement.
(2) The nursing facility is part of the CCRC campus.
Section 3. Certified and noncertified nursing facilities on
CCRC campus.
Where a licensed nursing facility is part of the continuum of
care of a CCRC and regardless of whether the nursing facility
currently has beds certified by the medical assistance program,
the nursing facility shall have a limited number of beds
certified by medical assistance through an application to the
department pursuant to the following requirements:
(1) One or more residents admitted under a continuing
care agreement spend down their resources, including any
funds which may be or may become available, as a full or
partial refund of any entrance fee payments, in order to
become eligible for medical assistance.
(2) The beds will be used to provide nursing care and to
maintain on the CCRC campus residents who have spent down
their resources in order to become eligible for medical
assistance.
(3) The number of beds certified by the medical
assistance program may not be greater than 15%, rounded to
the nearest whole number, of the current licensed number of
beds of the CCRC's nursing facility.
Section 4. Applications for nursing facility beds certified by
the medical assistance program.
(a) Required information.--The application for a bed
certified by the medical assistance program must include
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documentation that the person for whom the bed is requested was
initially admitted to the CCRC under the terms of a continuing
care agreement.
(b) Limitation.--All applications for beds certified by the
medical assistance program which satisfy subsection (a) shall be
granted by the department subject to the spend-down medical
assistance bed limitation as specified in section 3(3) and the
notice requirements specified in section 6.
(c) Agreement.--The nursing facility of the CCRC shall sign
a limited enrollment provider agreement.
Section 5. Nursing facility medical assistance reimbursement.
The nursing facility of the CCRC shall be eligible for and
shall receive reimbursement under the medical assistance program
as a participating provider effective on the date the medical
assistance eligible resident meets medical assistance
eligibility requirements.
Section 6. Department notification.
The nursing facility of the CCRC must notify the department
within 30 days of the death or permanent transfer or discharge
of the medical assistance eligible resident from the nursing
facility. Failure of the nursing facility to notify the
department of these events within 30 days may be used as a basis
to deny future applications for certified medical assistance
beds.
Section 7. Effective date.
This act shall take effect in 60 days.
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