Alabama 2022 Regular Session

Alabama House Bill HB285 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		1 HB285
2		-	2 216689-2
	2	+	2 216689-1
3	3		3 By Representative Clouse
4	4		4 RFD: Ways and Means General Fund
5	5		5 First Read: 08-FEB-22
6	6
7		-	Page 0 HB285
8		-	1
9		-	2 ENROLLED, An Act,
10		-	3 Relating to the privilege assessment for nursing
11		-	4 homes; to amend Section 40-26B-21, Code of Alabama 1975; to
12		-	5 extend the supplemental privilege assessment, the secondary
13		-	6 supplemental privilege assessment, and the surcharge through
14		-	7 August 31, 2025; and provide that the Medicaid nursing
15		-	8 facility program be administered by the Alabama Medicaid
16		-	9 Agency during the period that the privilege assessment is
17		-	10 levied and collected.
18		-	11 BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
19		-	12 Section 1. Section 40-26B-21, Code of Alabama 1975,
20		-	13 is amended to read as follows:
21		-	14 "§40-26B-21.
22		-	15 "To provide further for the availability of indigent
23		-	16 health care, the operation of the Medicaid program, and the
24		-	17 maintenance and expansion of medical services:
25		-	18 "(a) There is levied and shall be collected a
26		-	19 privilege assessment on the business activities of every
27		-	20 nursing facility in the State of Alabama. The privilege
28		-	21 assessment imposed is in addition to all other taxes and
29		-	22 assessments, and shall be at the annual rate of one thousand
30		-	23 eight hundred ninety-nine dollars and ninety-six cents
31		-	24 ($1,899.96) for each bed in the nursing facility. Beginning
32		-	25 September 1, 2020, the privilege assessment shall be increased
33		-	Page 1 HB285
34		-	1 from one thousand eight hundred ninety-nine dollars and
35		-	2 ninety-six cents ($1,899.96) for each bed in the nursing
36		-	3 facility, by an addition to the privilege assessment equal to
37		-	4 three hundred twenty-seven dollars and forty-eight cents
38		-	5 ($327.48) per annum. The addition to the privilege assessment
39		-	6 shall be paid in equal monthly installments and shall merge
40		-	7 into and be a part of the privilege assessment described in
41		-	8 this subsection. The payment to nursing facilities of the
42		-	9 determined allowable costs in respect to the addition to the
43		-	10 privilege assessment described in this subsection shall be
44		-	11 included in Medicaid per diem rates for services provided
45		-	12 commencing as of October 1, 2020, and shall continue to be
46		-	13 included in such Medicaid per diem rates in the same manner
47		-	14 that reimbursement for the privilege assessment is included in
48		-	15 Medicaid per diem rates. For each Medicaid nursing facility,
49		-	16 in determining the October 1, 2020 adjustment to the Medicaid
50		-	17 per diem for the allowable costs associated with the addition
51		-	18 to the privilege assessment, the Medicaid Agency shall divide
52		-	19 the total addition to the privilege assessment by the total of
53		-	20 all incurred resident days (regardless of payor class)
54		-	21 reported by each nursing facility in its Medicaid cost report
55		-	22 filed for the period then ended June 30, 2019. Notwithstanding
56		-	23 the foregoing, in the event that the June 30, 2019 cost report
57		-	24 is for a period of less than one year, the resident days
58		-	25 reported shall be annualized. After the October 1, 2020
59		-	Page 2 HB285
60		-	1 adjustment under this subsection, the addition to the
61		-	2 privilege assessment shall be fully merged into the privilege
62		-	3 assessment and reimbursed in accordance with the method set
63		-	4 forth for calculating the reimbursement for the privilege
64		-	5 assessment. In the event that any portion of the privilege
65		-	6 assessment paid by a facility cannot be included in the
66		-	7 computation of Medicaid per diem rate because of the effect of
67		-	8 any cost ceiling provision of the reimbursement methodology,
68		-	9 the cost ceiling shall be adjusted to ensure continued
69		-	10 treatment of the total privilege assessments as an allowable
70		-	11 cost.
71		-	12 "(b) For the period September 1, 2010, through
72		-	13 August 31, 2022 2025, there is levied and shall be collected a
73		-	14 supplemental privilege assessment on the business activities
74		-	15 of every nursing facility in the State of Alabama. The
75		-	16 supplemental privilege assessment imposed is in addition to
76		-	17 all other taxes and assessments, including without limitation,
77		-	18 the privilege taxes provided for under this article, and from
78		-	19 September 1, 2010, through August 31, 2011, shall be at the
79		-	20 annual rate of one thousand and sixty-three dollars and eight
80		-	21 cents ($1,063.08) for each bed in the nursing facility, and
81		-	22 one thousand six hundred three dollars and eight cents
82		-	23 ($1,603.08) for the period of September 1, 2011, through
83		-	24 August 31, 2022 2025, except that beginning with the monthly
84		-	25 payment for the supplemental privilege assessment due
85		-	Page 3 HB285
86		-	1 beginning May 20, 2012, and ending August 31, 2022 2025, there
87		-	2 shall be a monthly surcharge due with each monthly payment of
88		-	3 the supplemental privilege assessment. The initial monthly
89		-	4 surcharge shall be one hundred thirty-one dollars and
90		-	5 twenty-five cents ($131.25) per licensed bed. Beginning with
91		-	6 the monthly payment of the supplemental privilege assessment
92		-	7 due on September 20, 2012, the monthly surcharge shall be
93		-	8 reduced to forty-three dollars and seventy-five cents ($43.75)
94		-	9 per month.
95		-	10 "For the period October 1, 2015, through August 31,
96		-	11 2022 2025, there shall be collected a secondary supplemental
97		-	12 privilege assessment on the business activities of every
98		-	13 nursing facility in the State of Alabama. The secondary
99		-	14 supplemental privilege assessment imposed in this paragraph is
100		-	15 contingent upon the minimum appropriation provided in Section
101		-	16 2 of Act 2015-536, and is in addition to all other taxes and
102		-	17 assessments, including without limitation, the privilege taxes
103		-	18 provided for under this article, and beginning October 1,
104		-	19 2015, shall be at the annual rate of four hundred one dollars
105		-	20 and twenty-eight cents ($401.28) for each bed in the nursing
106		-	21 facility, payable monthly.
107		-	22 "(c) The total privilege assessment (and the
108		-	23 addition to the privilege assessment), supplemental privilege
109		-	24 assessment, secondary privilege assessment, (privilege
110		-	25 assessments) and surcharge paid by a nursing facility pursuant
111		-	Page 4 HB285
112		-	1 to this article shall be considered an allowable cost, as that
113		-	2 term is defined in the reimbursement methodology for nursing
114		-	3 facilities contained in Title 560 of the Alabama
115		-	4 Administrative Code, and, to the extent permitted under
116		-	5 applicable federal law governing the Alabama Medicaid nursing
117		-	6 home program, the total privilege assessments paid must be
118		-	7 included in the computation of the Medicaid per diem rate
119		-	8 determined under the reimbursement methodology for nursing
120		-	9 facilities contained in Title 560 of the Alabama
121		-	10 Administrative Code. The payment to nursing facilities of the
122		-	11 determined allowable costs in respect to the supplemental
123		-	12 privilege assessment described in subsection (b) shall be
124		-	13 included in Medicaid per diem rates for services provided
125		-	14 commencing as of January 1, 2011, and shall continue to be
126		-	15 included in such Medicaid per diem rates for a period equal to
127		-	16 the number of months during which the supplemental assessments
128		-	17 shall have been in effect. For each Medicaid nursing facility,
129		-	18 in determining the adjustment to the Medicaid per diem for the
130		-	19 allowable costs associated with the supplemental assessment,
131		-	20 the Medicaid Agency shall divide the total supplemental
132		-	21 assessment due under subsection (b) by the total of all
133		-	22 incurred resident days (regardless of payor class) reported by
134		-	23 such nursing facility in its Medicaid cost report filed for
135		-	24 the period then ended June 30, 2010. To accommodate the
136		-	25 increase in the supplemental assessment and the surcharge
137		-	Page 5 HB285
138		-	1 described in subsection (b), the agency shall use the
139		-	2 mechanism described herein to adjust each nursing facility's
140		-	3 rate effective as of October 1, 2011, regarding the privilege
141		-	4 assessment, and May 1, 2012, regarding the surcharge.
142		-	5 Notwithstanding the foregoing, in the event that such cost
143		-	6 report shall be for a period less than one year, the resident
144		-	7 days reported shall be annualized. In the event that any
145		-	8 portion of the privilege assessment paid by a facility cannot
146		-	9 be included in the computation of the Medicaid per diem rate
147		-	10 because of the effect of any cost ceiling provision of the
148		-	11 reimbursement methodology, the cost ceiling must be adjusted
149		-	12 to ensure continued treatment of the total privilege
150		-	13 assessments as an allowable cost.
151		-	14 "(d) The privilege assessment rate or the
152		-	15 supplemental privilege assessment rate or the surcharge rate
153		-	16 shall be reduced by the department upon the advice of the
154		-	17 Medicaid Agency if, but only if, such reduction is required to
155		-	18 ensure that the total revenues to the State of Alabama
156		-	19 produced by this privilege assessment or, if the supplemental
157		-	20 privilege assessment and surcharge are in effect, the
158		-	21 aggregate of the supplemental privilege assessment and
159		-	22 surcharge and the privilege assessment, during any state
160		-	23 fiscal year are less than or equal to six percent of the total
161		-	24 revenues received by the nursing facilities in the state
162		-	25 subject to the assessment during that same fiscal year. In the
163		-	Page 6 HB285
164		-	1 event that the supplemental privilege assessment or surcharge
165		-	2 are reduced as provided in the preceding sentence, then for
166		-	3 each Medicaid nursing facility a corresponding reduction shall
167		-	4 be made to the Medicaid per diem adjustment described in
168		-	5 subsection (c) to ensure that only the amount of supplemental
169		-	6 privilege assessment or surcharge actually paid is used in
170		-	7 computing that Medicaid nursing facility's allowable costs.
171		-	8 "(e) The Medicaid nursing facility program shall
172		-	9 continue to be administered directly by the Medicaid Agency
173		-	10 until at least October 1, 2022 during the period in which the
174		-	11 provider assessment provided by this section is levied and
175		-	12 collected."
176		-	13 Section 2. This act shall become effective
177		-	14 immediately following its passage and approval by the
178		-	15 Governor, or its otherwise becoming law.
179		-	Page 7 HB285
180		-	1
	7	+	Page 0 1 216689-1:n:01/25/2022:DJ/cmg LSA2022-029F
181	8		2
182	9		3
183	10		4
184		-	Speaker of the House of Representatives
185		-
186	11		5
187		-	6 President and Presiding Officer of the Senate
188		-	House of Representatives7
189		-	I hereby certify that the within Act originated in8
190		-	9 and was passed by the House 17-FEB-22.
191		-	10
192		-	11 Jeff Woodard
193		-	12 Clerk
194		-	13
195		-	14
196		-	15
197		-	Senate16 02-MAR-22 Passed
198		-	17
	12	+	6
	13	+	7
	14	+	8 SYNOPSIS: Existing law provides that the current
	15	+	9 supplemental privilege assessment, secondary
	16	+	10 supplemental privilege assessment, and surcharge
	17	+	11 that are imposed on each bed in a nursing facility
	18	+	12 expire on August 31, 2022.
	19	+	13 This bill would extend the current
	20	+	14 supplemental privilege assessment, secondary
	21	+	15 supplemental privilege assessment, and surcharge
	22	+	16 through August 31, 2025.
	23	+	17 This bill would also provide that the
	24	+	18 Medicaid nursing facility program be administered
	25	+	19 directly by the Alabama Medicaid Agency during the
	26	+	20 period in which the privilege assessment is levied
	27	+	21 and collected.
	28	+	22
	29	+	23 A BILL
	30	+	24 TO BE ENTITLED
	31	+	25 AN ACT
	32	+	26
	33	+	Page 1 1 Relating to the privilege assessment for nursing
	34	+	2 homes; to amend Section 40-26B-21, Code of Alabama 1975; to
	35	+	3 extend the supplemental privilege assessment, the secondary
	36	+	4 supplemental privilege assessment, and the surcharge through
	37	+	5 August 31, 2025; and provide that the Medicaid nursing
	38	+	6 facility program be administered by the Alabama Medicaid
	39	+	7 Agency during the period that the privilege assessment is
	40	+	8 levied and collected.
	41	+	9 BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
	42	+	10 Section 1. Section 40-26B-21, Code of Alabama 1975,
	43	+	11 is amended to read as follows:
	44	+	12 "§40-26B-21.
	45	+	13 "To provide further for the availability of indigent
	46	+	14 health care, the operation of the Medicaid program, and the
	47	+	15 maintenance and expansion of medical services:
	48	+	16 "(a) There is levied and shall be collected a
	49	+	17 privilege assessment on the business activities of every
	50	+	18 nursing facility in the State of Alabama. The privilege
	51	+	19 assessment imposed is in addition to all other taxes and
	52	+	20 assessments, and shall be at the annual rate of one thousand
	53	+	21 eight hundred ninety-nine dollars and ninety-six cents
	54	+	22 ($1,899.96) for each bed in the nursing facility. Beginning
	55	+	23 September 1, 2020, the privilege assessment shall be increased
	56	+	24 from one thousand eight hundred ninety-nine dollars and
	57	+	25 ninety-six cents ($1,899.96) for each bed in the nursing
	58	+	26 facility, by an addition to the privilege assessment equal to
	59	+	27 three hundred twenty-seven dollars and forty-eight cents
	60	+	Page 2 1 ($327.48) per annum. The addition to the privilege assessment
	61	+	2 shall be paid in equal monthly installments and shall merge
	62	+	3 into and be a part of the privilege assessment described in
	63	+	4 this subsection. The payment to nursing facilities of the
	64	+	5 determined allowable costs in respect to the addition to the
	65	+	6 privilege assessment described in this subsection shall be
	66	+	7 included in Medicaid per diem rates for services provided
	67	+	8 commencing as of October 1, 2020, and shall continue to be
	68	+	9 included in such Medicaid per diem rates in the same manner
	69	+	10 that reimbursement for the privilege assessment is included in
	70	+	11 Medicaid per diem rates. For each Medicaid nursing facility,
	71	+	12 in determining the October 1, 2020 adjustment to the Medicaid
	72	+	13 per diem for the allowable costs associated with the addition
	73	+	14 to the privilege assessment, the Medicaid Agency shall divide
	74	+	15 the total addition to the privilege assessment by the total of
	75	+	16 all incurred resident days (regardless of payor class)
	76	+	17 reported by each nursing facility in its Medicaid cost report
	77	+	18 filed for the period then ended June 30, 2019. Notwithstanding
	78	+	19 the foregoing, in the event that the June 30, 2019 cost report
	79	+	20 is for a period of less than one year, the resident days
	80	+	21 reported shall be annualized. After the October 1, 2020
	81	+	22 adjustment under this subsection, the addition to the
	82	+	23 privilege assessment shall be fully merged into the privilege
	83	+	24 assessment and reimbursed in accordance with the method set
	84	+	25 forth for calculating the reimbursement for the privilege
	85	+	26 assessment. In the event that any portion of the privilege
	86	+	27 assessment paid by a facility cannot be included in the
	87	+	Page 3 1 computation of Medicaid per diem rate because of the effect of
	88	+	2 any cost ceiling provision of the reimbursement methodology,
	89	+	3 the cost ceiling shall be adjusted to ensure continued
	90	+	4 treatment of the total privilege assessments as an allowable
	91	+	5 cost.
	92	+	6 "(b) For the period September 1, 2010, through
	93	+	7 August 31, 2022 2025, there is levied and shall be collected a
	94	+	8 supplemental privilege assessment on the business activities
	95	+	9 of every nursing facility in the State of Alabama. The
	96	+	10 supplemental privilege assessment imposed is in addition to
	97	+	11 all other taxes and assessments, including without limitation,
	98	+	12 the privilege taxes provided for under this article, and from
	99	+	13 September 1, 2010, through August 31, 2011, shall be at the
	100	+	14 annual rate of one thousand and sixty-three dollars and eight
	101	+	15 cents ($1,063.08) for each bed in the nursing facility, and
	102	+	16 one thousand six hundred three dollars and eight cents
	103	+	17 ($1,603.08) for the period of September 1, 2011, through
	104	+	18 August 31, 2022 2025, except that beginning with the monthly
	105	+	19 payment for the supplemental privilege assessment due
	106	+	20 beginning May 20, 2012, and ending August 31, 2022 2025, there
	107	+	21 shall be a monthly surcharge due with each monthly payment of
	108	+	22 the supplemental privilege assessment. The initial monthly
	109	+	23 surcharge shall be one hundred thirty-one dollars and
	110	+	24 twenty-five cents ($131.25) per licensed bed. Beginning with
	111	+	25 the monthly payment of the supplemental privilege assessment
	112	+	26 due on September 20, 2012, the monthly surcharge shall be
	113	+	Page 4 1 reduced to forty-three dollars and seventy-five cents ($43.75)
	114	+	2 per month.
	115	+	3 "For the period October 1, 2015, through August 31,
	116	+	4 2022 2025, there shall be collected a secondary supplemental
	117	+	5 privilege assessment on the business activities of every
	118	+	6 nursing facility in the State of Alabama. The secondary
	119	+	7 supplemental privilege assessment imposed in this paragraph is
	120	+	8 contingent upon the minimum appropriation provided in Section
	121	+	9 2 of Act 2015-536, and is in addition to all other taxes and
	122	+	10 assessments, including without limitation, the privilege taxes
	123	+	11 provided for under this article, and beginning October 1,
	124	+	12 2015, shall be at the annual rate of four hundred one dollars
	125	+	13 and twenty-eight cents ($401.28) for each bed in the nursing
	126	+	14 facility, payable monthly.
	127	+	15 "(c) The total privilege assessment (and the
	128	+	16 addition to the privilege assessment), supplemental privilege
	129	+	17 assessment, secondary privilege assessment, (privilege
	130	+	18 assessments) and surcharge paid by a nursing facility pursuant
	131	+	19 to this article shall be considered an allowable cost, as that
	132	+	20 term is defined in the reimbursement methodology for nursing
	133	+	21 facilities contained in Title 560 of the Alabama
	134	+	22 Administrative Code, and, to the extent permitted under
	135	+	23 applicable federal law governing the Alabama Medicaid nursing
	136	+	24 home program, the total privilege assessments paid must be
	137	+	25 included in the computation of the Medicaid per diem rate
	138	+	26 determined under the reimbursement methodology for nursing
	139	+	27 facilities contained in Title 560 of the Alabama
	140	+	Page 5 1 Administrative Code. The payment to nursing facilities of the
	141	+	2 determined allowable costs in respect to the supplemental
	142	+	3 privilege assessment described in subsection (b) shall be
	143	+	4 included in Medicaid per diem rates for services provided
	144	+	5 commencing as of January 1, 2011, and shall continue to be
	145	+	6 included in such Medicaid per diem rates for a period equal to
	146	+	7 the number of months during which the supplemental assessments
	147	+	8 shall have been in effect. For each Medicaid nursing facility,
	148	+	9 in determining the adjustment to the Medicaid per diem for the
	149	+	10 allowable costs associated with the supplemental assessment,
	150	+	11 the Medicaid Agency shall divide the total supplemental
	151	+	12 assessment due under subsection (b) by the total of all
	152	+	13 incurred resident days (regardless of payor class) reported by
	153	+	14 such nursing facility in its Medicaid cost report filed for
	154	+	15 the period then ended June 30, 2010. To accommodate the
	155	+	16 increase in the supplemental assessment and the surcharge
	156	+	17 described in subsection (b), the agency shall use the
	157	+	18 mechanism described herein to adjust each nursing facility's
	158	+	19 rate effective as of October 1, 2011, regarding the privilege
	159	+	20 assessment, and May 1, 2012, regarding the surcharge.
	160	+	21 Notwithstanding the foregoing, in the event that such cost
	161	+	22 report shall be for a period less than one year, the resident
	162	+	23 days reported shall be annualized. In the event that any
	163	+	24 portion of the privilege assessment paid by a facility cannot
	164	+	25 be included in the computation of the Medicaid per diem rate
	165	+	26 because of the effect of any cost ceiling provision of the
	166	+	27 reimbursement methodology, the cost ceiling must be adjusted
	167	+	Page 6 1 to ensure continued treatment of the total privilege
	168	+	2 assessments as an allowable cost.
	169	+	3 "(d) The privilege assessment rate or the
	170	+	4 supplemental privilege assessment rate or the surcharge rate
	171	+	5 shall be reduced by the department upon the advice of the
	172	+	6 Medicaid Agency if, but only if, such reduction is required to
	173	+	7 ensure that the total revenues to the State of Alabama
	174	+	8 produced by this privilege assessment or, if the supplemental
	175	+	9 privilege assessment and surcharge are in effect, the
	176	+	10 aggregate of the supplemental privilege assessment and
	177	+	11 surcharge and the privilege assessment, during any state
	178	+	12 fiscal year are less than or equal to six percent of the total
	179	+	13 revenues received by the nursing facilities in the state
	180	+	14 subject to the assessment during that same fiscal year. In the
	181	+	15 event that the supplemental privilege assessment or surcharge
	182	+	16 are reduced as provided in the preceding sentence, then for
	183	+	17 each Medicaid nursing facility a corresponding reduction shall
	184	+	18 be made to the Medicaid per diem adjustment described in
	185	+	19 subsection (c) to ensure that only the amount of supplemental
	186	+	20 privilege assessment or surcharge actually paid is used in
	187	+	21 computing that Medicaid nursing facility's allowable costs.
	188	+	22 "(e) The Medicaid nursing facility program shall
	189	+	23 continue to be administered directly by the Medicaid Agency
	190	+	24 until at least October 1, 2022 during the period in which the
	191	+	25 provider assessment provided by this section is levied and
	192	+	26 collected."
	193	+	Page 7 1 Section 2. This act shall become effective
	194	+	2 immediately following its passage and approval by the
	195	+	3 Governor, or its otherwise becoming law.
199	196		Page 8