Second Regular Session
Seventy-third General Assembly
STATE OF COLORADO
REVISED
This Version Includes All Amendments Adopted
on Second Reading in the Second House
LLS NO. 22-0850.01 Jane Ritter x4342
HOUSE BILL 22-1247
House Committees Senate Committees
Public & Behavioral Health & Human Services Appropriations
Appropriations
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;
SENATE
2nd Reading Unamended
April 1, 2022
HOUSE
3rd Reading Unamended
March 17, 2022
HOUSE
Amended 2nd Reading
March 16, 2022
HOUSE SPONSORSHIP
Herod and McCluskie, Ransom, Bernett, Bird, Bockenfeld, Boesenecker, Caraveo,
Cutter, Duran, Esgar, Exum, Froelich, Gonzales-Gutierrez, Hooton, Jodeh, Kennedy, Kipp,
Lindsay, Lontine, McCormick, McLachlan, Michaelson Jenet, Mullica, Ricks, Soper, Titone,
Valdez A., Valdez D., Woodrow, Young
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
SHALL ISSUE ADDITIONAL9
SUPPLEMENTAL PAYMENTS TO NURSING FACILITY PROVIDERS THAT MEET10
THE REQUIREMENTS OUTLINED IN THIS SECTION AND THE STATE11
DEPARTMENT'S SUBSEQUENT REGULATION AS FOLLOWS :12
(a) F
OR THE 2021-22 STATE FISCAL YEAR, FUNDS APPROPRIATED13
BY THE GENERAL ASSEMBLY ARE FOR THE PURPOSES OF SUPPORTING14
NURSING FACILITY PROVIDERS EXPERIENCING INCREASED STAFFING COSTS15
RESULTING FROM THE COVID-19 PANDEMIC, NURSING FACILITY16
1247-2- PROVIDERS WITH HIGH MEDICAID UTILIZATION RATES , OR NURSING1
FACILITY PROVIDERS CURRENTLY SERVING INDIVIDUALS WITH COMPLEX2
NEEDS.3
(b) P
AYMENTS MADE IN ADDITION TO THOSE SPECIFIED IN4
SUBSECTION (1)(a) OF THIS SECTION MAY ALSO BE MADE TO NURSING5
FACILITY PROVIDERS THAT ACCEPT NEW ADMISSIONS OF6
MEDICAID-ENROLLMENT INDIVIDUALS WITH COMPLEX NEEDS .7
(2) T
HE STATE DEPARTMENT SHALL ESTABLISH REPORTING AND8
RESULT TRACKING REQUIREMENTS NECESSARY TO ADMINISTER THE9
FUNDING OUTLINED IN THIS SECTION. THE STATE DEPARTMENT MAY DENY10
OR RECOUP FUNDING FROM NURSING FACILITY PROVIDERS THAT ARE11
NONCOMPLIANT WITH REPORTING REQUIREMENTS OR IF FUNDING IS USED12
FOR PURPOSES OUTSIDE THE INTENT OF SUPPORTING AND STABILIZING13
NURSING FACILITY PROVIDERS THAT ARE MEDICAID PROVIDERS .14
(3) T
HE STATE DEPARTMENT SHALL EVALUATE PROVIDER15
OUTCOMES, INCLUDING CHANGES IN CAPACITY , ASSOCIATED WITH THE16
PAYMENT OF SUPPLEMENTAL MONEY TO NURSING FACILITY PROVIDERS .17
T
HE STATE DEPARTMENT SHALL UTILIZE NURSING FACILITY PROVIDERS '18
FINANCIAL STATEMENTS AND LABOR AND WAGE RECORDS TO EVALUATE19
THE RESULTS OF PAYMENTS.20
(4) (a) T
HE STATE DEPARTMENT SHALL PURSUE FEDERAL21
MATCHING FUNDS. IF FEDERAL MATCHING FUNDS ARE UNAVAILABLE FOR22
ANY REASON, PAYMENTS OUTLINED IN THIS SECTION MAY BE REDUCED OR23
RESTRICTED, SUBJECT TO AVAILABLE FUNDING.24
(b) F
OR THE PURPOSES OF FEDERAL UPPER PAYMENT LIMIT25
CALCULATIONS, THE STATE DEPARTMENT SHALL PURSUE FEDERAL26
MATCHING FUNDS FOR PAYMENTS MADE PURSUANT TO THIS SECTION BUT27
1247
-3- ONLY AFTER SECURING FEDERAL MATCHING FUNDS FOR PAYMENTS1
OUTLINED IN SECTIONS 25.5-6-203 (2) AND 25.5-6-208.2
(5) (a) S
UPPLEMENTAL PAYMENTS MADE TO NURSING FACILITY3
PROVIDERS PURSUANT TO THIS SECT ION MUST BE DETERMINED BASED ON4
THE MOST RECENT AVAILABLE DATA .5
(b) P
URSUANT TO RULES PROMULGATED BY THE STATE6
DEPARTMENT, PAYMENTS RECEIVED PURSUANT TO THIS SECTION MUST
BE7
REPORTED AS REVENUE ON THE ANNUAL COST REPORT WHEN8
CALCULATING NURSING FACILITY PROVIDER PER DIEM REIMBURSEMENT AS9
DIRECTED BY THE STATE DEPARTMENT .10
(6) T
O RECEIVE AN ADDITIONAL PAYMENT PURSUANT TO11
SUBSECTION (1)(b) OF THIS SECTION, A NURSING FACILITY PROVIDER12 SHALL WORK WITH A HOSPITAL TO FACILITATE THE TIMELY DISCHARGE OF13
MEDICAID MEMBERS FROM THE HOSPITAL INTO THE NURSING FACILITY,14
SERVE MEDICAID MEMBERS WITH COMPLEX NEEDS, OR ACCEPT15
COMPASSIONATE RELEASE INDIVIDUALS FROM THE DEPARTMENT OF16
CORRECTIONS.17
(7) O
N OR BEFORE NOVEMBER 1, 2022, THE STATE DEPARTMENT18
SHALL ENGAGE WITH STAKEHOLDERS AND SUBMIT A REPORT AND19
RECOMMENDATIONS TO THE JOINT BUDGET COMMITTEE , THE HEALTH AND20
HUMAN SERVICES COMMITTEE OF THE SENATE , AND THE PUBLIC AND21
BEHAVIORAL HEALTH AND HUMAN SERVICES COMMITTEE OF THE HOUSE OF22
REPRESENTATIVES, OR ANY SUCCESSOR COMMITTEES , CONCERNING23
SUGGESTED CHANGES FOR PERMANENTLY CHANGING MEDICAID NURSING24
FACILITY PROVIDER REIMBURSEMENT POLICY IN COLORADO TO PRIORITIZE25
QUALITY, SUSTAINABILITY, AND SOUND FISCAL STEWARDSHIP TO AVOID26
FURTHER ONE-TIME CASH INFUSIONS. THE REPORT MUST INCLUDE27
1247
-4- CHANGES THAT CAN BE MADE TO AFFIRM A NURSING FACILITY PROVIDER 'S1
COMMITMENT TO ACCOUNTABILITY AND MUST INCLUDE , AT A MINIMUM:2
(a) I
NFECTION CONTROL AND CULTURE CHANGE PRACTICES ,3
INCLUDING:4
(I) S
INGLE OCCUPANCY ROOMS ;5
(II) S
MALLER FACILITY MODELS; AND6
(III) I
NNOVATIVE FACILITY MODELS;7
(b) B
EHAVIORAL HEALTH NEEDS ;8
(c) P
RACTICES REGARDING INDIVIDUALS WHO HAVE COMPLEX9
NEEDS REQUIRING HOSPITAL DISCHARGE ;10
(d) P
RACTICES REGARDING CARE AND SERVICES TO11
COMPASSIONATE RELEASE INDIVIDUALS FROM THE DEPARTMENT OF12
CORRECTIONS;13
(e) O
PTIONS FOR DIVERSIFIED FUNDING STREAMS TO ENSURE14
CONTINUITY OF SERVICES;15
(f) C
OMPETITIVE STAFFING PRACTICES;16
(g) T
HE TIMELINE AND COSTS ASSOCIATED WITH IMPLEMENTING17
THE RECOMMENDED CHANGES , INCLUDING THE IMPACT ON NURSING18
FACILITY PROVIDER RATES; AND19
(h) I
DENTIFICATION OF THE AMOUNT OF SUPPLEMENTAL PAYMENTS20
TO EACH NURSING FACILITY PROVIDER AND THE OUTCOME EVALUATION21
REQUIRED PURSUANT TO SUBSECTION (3) OF THIS SECTION.22
(8) T
HE STATE DEPARTMENT SHALL MEET WITH THE FOLLOWING23
STAKEHOLDERS, AT A MINIMUM, TO SEEK INPUT ON ANY PROPOSED24
REIMBURSEMENT METHODOLOGY CHANGES AND REPORT AS REQUIRED BY25
THIS SECTION:26
(a) A
REPRESENTATIVE FROM AN URBAN NURSING FACILITY27
1247
-5- PROVIDER;1
(b) A
REPRESENTATIVE FROM A RURAL NURSING FACILITY2
PROVIDER;3
(c) A
REPRESENTATIVE FROM A NURSING FACILITY TRADE4
ORGANIZATION;5
(d) A
REPRESENTATIVE FROM A NURSING FACILITY WITH A HIGH6
MEDICAID UTILIZATION RATE; AND7
(e) A
REPRESENTATIVE FROM A NURSING FACILITY THAT SERVES8
INDIVIDUALS WITH COMPLEX NEEDS .9
(9) T
HE STATE BOARD SHALL PROMULGATE ANY RULES NECESSARY10
TO IMPLEMENT THIS SECTION.11
(10) T
HIS SECTION IS REPEALED, EFFECTIVE JULY 1, 2023.12
SECTION 2. Appropriation. (1) For the 2021-22 state fiscal13
year, $17,000,500 is appropriated to the department of health care policy14
and financing for use by medical services premiums. This appropriation15
is from the general fund and is subject to the "(M)" notation as defined in16
the annual general appropriation act for the same fiscal year. To17
implement this act, the department may use this appropriation for medical18
and long-term care services for Medicaid-eligible individuals.19
(2) For the 2021-22 state fiscal year, the general assembly20
anticipates that the department of health care policy and financing will21
receive $10,000,500 in federal funds to implement this act. The22
appropriation in subsection (1) of this section is based on the assumption23
that the department will receive this amount of federal funds to be used24
for medical and long-term care services for Medicaid-eligible individuals.25
(3) Any money appropriated in subsection (1) of this section not26
expended prior to July 1, 2022, is further appropriated to the department27
1247
-6- for the 2022-23 state fiscal year for the same purpose.1
SECTION 3. Safety clause. The general assembly hereby finds,2
determines, and declares that this act is necessary for the immediate3
preservation of the public peace, health, or safety.4
1247
-7-