sb 0167

CHAPTER 198

SB 167-FN-A - FINAL VERSION

AN ACT relative to the medicaid payment for long-term care services.

SPONSORS: Sen. Gordon, Dist 2; Sen. Johnson, Dist 3; Rep. Blanchard, Rock 33; Rep. P. Katsakiores, Rock 13; Rep. Francoeur, Rock 22; Rep. M. Fuller Clark, Rock 36

This bill requires the commissioner of health and human services to develop a revised rate setting structure for medicaid payment of nursing home facility services. This bill also creates a long-term care rate advisory committee, which shall review the rate setting structure for reimbursement of nursing facilities established by the commissioner of health and human services and report on or before September 1, 2002 and at least every 2 years thereafter to the president of the senate, the speaker of the house, and the governor and executive council on the status of the rate setting structure.

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

AN ACT relative to the medicaid payment for long-term care services.

Be it Enacted by the Senate and House of Representatives in General Court convened:

198:1 Intent. The general court recognizes that the elderly represent a growing population that will require long-term care services. Therefore, it is important to review the rates paid to all providers of long-term care in order to allocate resources for the provision of these services.

198:2 New Sections; Long-Term Care Rate Advisory Committee. Amend RSA 151-E by inserting after section 6 the following new sections:

I.(a) There is hereby established a long-term care rate advisory committee to advise the department of health and human services regarding long-term care payment rates. The committee shall be appointed by the commissioner of the department of health and human services and shall consist of the following members:

(1) Two members of the house of representatives, one of whom shall be from the health and human services, and elderly affairs committee, appointed by the speaker of the house.

(3) Two persons representing county nursing facilities, recommended by the New Hampshire Association of Counties.

(4) Two persons representing private nursing facilities, recommended by the New Hampshire Health Care Association.

(5) Two persons representing home health care providers, including one for-profit provider and one not-for-profit provider, recommended by the Home Health Care Association of New Hampshire.

(6) Two persons representing adult medical day care providers, recommended by the Adult Medical Day Care Providers Association.

(7) One person representing meals on wheels providers, recommended by the New Hampshire Nutrition Providers Association.

(8) One person representing transportation providers, recommended by the New Hampshire Association of Transportation Providers.

(9) One person representing other qualified agencies that provide personal care services, recommended by any such agencies.

(11) One person representing residential care providers, recommended by the Association of Residential Care Homes of New Hampshire.

(13) Two persons representing ServiceLink New Hampshire, one from a rural area and one from an urban area, recommended by the ServiceLink New Hampshire network.

(15) One certified nurse assistant, recommended by the New Hampshire board of nursing.

(b) The legislative members of the committee shall receive mileage at the legislative rate when attending to the duties of the committee.

(c) The committee shall review the commissioner's rate setting structure for reimbursement of long-term care providers, required under paragraph II, and submit its report, together with its recommendation for legislation to the president of the senate, the speaker of the house, the governor and the executive council on or before September 1, 2002 and at least every 2 years thereafter.

II. The long-term care rate advisory committee shall evaluate long-term care provider rate payments and make recommendations to the department. The commissioner shall include the results and outcome of this analysis in the report required in subparagraph I(c). This analysis shall be completed periodically and not less frequently than every 2 years.

151-E:6-b Memorandum of Agreement. The department of health and human services shall establish, by means of a memorandum of agreement with the New Hampshire Association of Counties, a mechanism for the receipt of input from the Association of Counties regarding the type, cost, utilization, and procedures relative to payments which the counties are obligated to make pursuant to RSA 167:18-b. The memorandum of agreement shall be reviewed annually and amended as may be determined to be necessary by the parties.

151-E:6-c Payment System for Nursing Facilities. The payment system for nursing facility level of care shall be as follows:

I. Rate calculation worksheets for all providers will be provided at least 30 days prior to the effective date of any rate changes.

II. Acuity levels must be updated at least semi-annually, on a regular, predictable basis using the latest available data.

III. The commissioner of the department of health and human services shall continue to evaluate the effectiveness of the acuity-based payment system for medicaid payments for nursing facility care. The commissioner shall determine if any changes in the payment system are appropriate.

IV. Any changes to the payment system for medicaid services in nursing facilities in this section shall be completed as quickly as possible but no later than March 1, 2002.

V. Any rate changes due to the updating of acuity or cost data shall occur only with proper prior notification and explanation to affected providers and the affected beneficiary population.