Second Regular Session
Seventy-third General Assembly
STATE OF COLORADO
INTRODUCED
LLS NO. 22-0850.01 Jane Ritter x4342
HOUSE BILL 22-1247
House Committees Senate Committees
Public & Behavioral Health & Human Services
A BILL FOR AN ACT
C
ONCERNING REQUIREMENTS FOR ADDITIONAL SUPPLEMENTAL101
PAYMENTS FOR NURSING FACILITY PROVIDERS , AND, IN102
CONNECTION THEREWITH , MAKING AN APPROPRIATION .103
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov/
.)
Joint Budget Committee. The bill directs the department of
health care policy and financing (department) to do the following, with
respect to nursing facility providers (nursing facilities):
! Issue additional supplemental payments as directed for the
2021-22 state fiscal year;
HOUSE SPONSORSHIP
Herod and McCluskie, Ransom
SENATE SPONSORSHIP
Hansen and Rankin, Moreno
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing statute.
Dashes through the words indicate deletions from existing statute. ! Establish reporting and result tracking requirements
necessary to administer additional supplemental funding;
! Pursue federal matching funds to reduce the state share of
costs to the maximum amount possible; and
! Engage with stakeholders to produce a report including
ways to improve methodology, practices regarding care and
services to compassionate release individuals from the
department of corrections, and funding for nursing
facilities. The department shall submit the report to the
joint budget committee and committees of the general
assembly on or before November 1, 2022.
The bill grants the department authority to promulgate rules as
necessary for implementation of the payments and their supporting
requirements.
The supplemental payments and their supporting requirements are
repealed, effective July 1, 2023.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, add 25.5-6-210 as2
follows:3
25.5-6-210. Additional supplemental payments - nursing4
facilities - funding methodology - reporting requirement - rules -5
repeal. (1) N
OTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE6
CONTRARY AND SUBJECT TO AVAILABLE APPROPRIATIONS , FOR THE7
PURPOSES OF REIMBURSING A MEDICAID -CERTIFIED CLASS I NURSING8
FACILITY PROVIDER, THE STATE DEPARTMENT MAY ISSUE ADDITIONAL9
SUPPLEMENTAL PAYMENTS AS FOLLOWS :10
(a) F
OR THE 2021-22 STATE FISCAL YEAR, FUNDS APPROPRIATED11
BY THE GENERAL ASSEMBLY ARE FOR THE PURPOSES OF SUPPORTING12
NURSING FACILITY PROVIDERS EXPERIENCING INCREASED STAFFING COSTS13
RESULTING FROM THE COVID-19 PANDEMIC, NURSING FACILITY14
PROVIDERS WITH HIGH MEDICAID UTILIZATION RATES , OR NURSING15
FACILITY PROVIDERS CURRENTLY SERVING INDIVIDUALS WITH COMPLEX16
HB22-1247-2- NEEDS.1
(b) P
AYMENTS MADE IN ADDITION TO THOSE SPECIFIED IN2
SUBSECTION (1)(a) OF THIS SECTION MAY ALSO BE MADE TO NURSING3
FACILITY PROVIDERS THAT ACCEPT NEW ADMISSIONS OF4
MEDICAID-ENROLLMENT INDIVIDUALS WITH COMPLEX NEEDS .5
(2) T
HE STATE DEPARTMENT SHALL ESTABLISH REPORTING AND6
RESULT TRACKING REQUIREMENTS NECESSARY TO ADMINISTER THE7
FUNDING OUTLINED IN THIS SECTION. THE STATE DEPARTMENT MAY DENY8
OR RECOUP FUNDING FROM NURSING FACILITY PROVIDERS THAT ARE9
NONCOMPLIANT WITH REPORTING REQUIREMENTS OR IF FUNDING IS USED10
FOR PURPOSES OUTSIDE THE INTENT OF SUPPORTING AND STABILIZING11
NURSING FACILITY PROVIDERS THAT ARE MEDICAID PROVIDERS .12
(3) T
HE STATE DEPARTMENT SHALL EVALUATE PROVIDER13
OUTCOMES, INCLUDING CHANGES IN CAPACITY , ASSOCIATED WITH THE14
PAYMENT OF SUPPLEMENTAL MONEY TO NURSING FACILITY PROVIDERS .15
T
HE STATE DEPARTMENT SHALL UTILIZE NURSING FACILITY PROVIDERS '16
FINANCIAL STATEMENTS AND LABOR AND WAGE RECORDS TO EVALUATE17
THE RESULTS OF PAYMENTS.18
(4) (a) T
HE STATE DEPARTMENT SHALL PURSUE FEDERAL19
MATCHING FUNDS. IF FEDERAL MATCHING FUNDS ARE UNAVAILABLE FOR20
ANY REASON, PAYMENTS OUTLINED IN THIS SECTION MAY BE REDUCED OR21
RESTRICTED, SUBJECT TO AVAILABLE FUNDING.22
(b) F
OR THE PURPOSES OF FEDERAL UPPER PAYMENT LIMIT23
CALCULATIONS, THE STATE DEPARTMENT SHALL PURSUE FEDERAL24
MATCHING FUNDS FOR PAYMENTS MADE PURSUANT TO THIS SECTION BUT25
ONLY AFTER SECURING FEDERAL MATCHING FUNDS FOR PAYMENTS26
OUTLINED IN SECTIONS 25.5-6-203 (2) AND 25.5-6-208.27
HB22-1247
-3- (5) (a) SUPPLEMENTAL PAYMENTS MADE TO NURSING FACILITY1
PROVIDERS PURSUANT TO THIS SECT ION MUST BE DETERMINED BASED ON2
THE MOST RECENT AVAILABLE DATA .3
(b) P
URSUANT TO RULES PROMULGATED BY THE STATE4
DEPARTMENT, PAYMENTS RECEIVED PURSUANT TO THIS SECTION MUST5
OFFSET COSTS REPORTED ON THE ANNUAL COST REPORT WHEN6
CALCULATING NURSING FACILITY PROVIDER PER DIEM REIMBURSEMENT .7
(6) T
O RECEIVE AN ADDITIONAL PAYMENT PURSUANT TO8
SUBSECTION (1)(b) OF THIS SECTION, A NURSING FACILITY PROVIDER9
SHALL COMMIT TO ADDITIONAL RESPONSIBILITY BY WORKING TO10
DISCHARGE MEDICAID MEMBERS FROM A HOSPITAL INTO THE NURSING11
FACILITY, SERVE MEDICAID MEMBERS WITH BEHAVIORAL HEALTH NEEDS ,12
OR ACCEPT COMPASSIONATE RELEASE INDIVIDUALS FROM THE13
DEPARTMENT OF CORRECTIONS .14
(7) O
N OR BEFORE NOVEMBER 1, 2022, THE STATE DEPARTMENT15
SHALL ENGAGE WITH STAKEHOLDERS AND SUBMIT A REPORT AND16
RECOMMENDATIONS TO THE JOINT BUDGET COMMITTEE , THE HEALTH AND17
HUMAN SERVICES COMMITTEE OF THE SENATE , AND THE PUBLIC AND18
BEHAVIORAL HEALTH AND HUMAN SERVICES COMMI TTEE OF THE HOUSE OF19
REPRESENTATIVES, OR ANY SUCCESSOR COMMITTEES , CONCERNING20
SUGGESTED CHANGES FOR PERMANENTLY CHANGING MEDICAID NURSING21
FACILITY PROVIDER REIMBURSEMENT POLICY IN COLORADO TO PRIORITIZE22
QUALITY, SUSTAINABILITY, AND SOUND FISCAL STEWARDSHIP TO AVOID23
FURTHER ONE-TIME CASH INFUSIONS. THE REPORT MUST INCLUDE24
CHANGES THAT CAN BE MADE TO AFFIRM A NURSING FACILITY PROVIDER 'S25
COMMITMENT TO ACCOUNTABILITY AND MUST INCLUDE , AT A MINIMUM:26
(a) I
NFECTION CONTROL AND CULTURE CHANGE PRACTICES ,27
HB22-1247
-4- INCLUDING:1
(I) S
INGLE OCCUPANCY ROOMS ;2
(II) S
MALLER FACILITY MODELS; AND3
(III) I
NNOVATIVE FACILITY MODELS;4
(b) B
EHAVIORAL HEALTH NEEDS ;5
(c) P
RACTICES REGARDING INDIVIDUALS WHO HAVE COMPLEX6
NEEDS REQUIRING HOSPITAL DISCHARGE ;7
(d) P
RACTICES REGARDING CARE AND SERVICES TO8
COMPASSIONATE RELEASE INDIVIDUALS FROM THE DEPARTMENT OF9
CORRECTIONS;10
(e) O
PTIONS FOR DIVERSIFIED FUNDING STREAMS TO ENSURE11
CONTINUITY OF SERVICES;12
(f) C
OMPETITIVE STAFFING PRACTICES;13
(g) T
HE TIMELINE AND COSTS ASSOCIATED WITH IMPLEMENTING14
THE RECOMMENDED CHANGES , INCLUDING THE IMPACT ON NURSING15
FACILITY PROVIDER RATES; AND16
(h) I
DENTIFICATION OF THE AMOUNT OF SUPPLEMENTAL PAYMENTS17
TO EACH NURSING FACILITY PROVIDER AND THE OUTCOME EVALUATION18
REQUIRED PURSUANT TO SUBSECTION (3) OF THIS SECTION.19
(8) T
HE STATE DEPARTMENT SHALL MEET WITH THE FOLLOWING20
STAKEHOLDERS, AT A MINIMUM, TO SEEK INPUT ON ANY PROPOSED21
REIMBURSEMENT METHODOLOGY CHANGES AND REPORT AS REQUIRED BY22
THIS SECTION:23
(a) A
REPRESENTATIVE FROM AN URBAN NURSING FACILITY24
PROVIDER;25
(b) A
REPRESENTATIVE FROM A RURAL NURSING FACILITY26
PROVIDER;27
HB22-1247
-5- (c) A REPRESENTATIVE FROM A NURSING FACILITY TRADE1
ORGANIZATION;2
(d) A
REPRESENTATIVE FROM A NURSING FACILITY WITH A HIGH3
MEDICAID UTILIZATION RATE; AND4
(e) A
REPRESENTATIVE FROM A NURSING FACILITY THAT SERVES5
INDIVIDUALS WITH COMPLEX NEEDS .6
(9) T
HE STATE BOARD SHALL PROMULGATE ANY RULES NECESSARY7
TO IMPLEMENT THIS SECTION.8
(10) T
HIS SECTION IS REPEALED, EFFECTIVE JULY 1, 2023.9
SECTION 2. Appropriation. (1) For the 2021-22 state fiscal10
year, $17,000,500 is appropriated to the department of health care policy11
and financing for use by medical services premiums. This appropriation12
is from the general fund and is subject to the "(M)" notation as defined in13
the annual general appropriation act for the same fiscal year. To14
implement this act, the department may use this appropriation for medical15
and long-term care services for Medicaid-eligible individuals.16
(2) For the 2021-22 state fiscal year, the general assembly17
anticipates that the department of health care policy and financing will18
receive $10,000,500 in federal funds to implement this act. The19
appropriation in subsection (1) of this section is based on the assumption20
that the department will receive this amount of federal funds to be used21
for medical and long-term care services for Medicaid-eligible individuals.22
(3) Any money appropriated in subsection (1) of this section not23
expended prior to July 1, 2022, is further appropriated to the department24
for the 2022-23 state fiscal year for the same purpose.25
SECTION 3. Safety clause. The general assembly hereby finds,26
HB22-1247
-6- determines, and declares that this act is necessary for the immediate1
preservation of the public peace, health, or safety.2
HB22-1247
-7-