HOUSE BILL 22-1247
BY REPRESENTATIVE(S) 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;
also SENATOR(S) Hansen and Rankin, Moreno, Buckner, Cooke, Fields,
Ginal, Kirkmeyer, Lee, Liston, Pettersen, Priola, Smallwood, Story,
Woodward, Zenzinger.
C
ONCERNING REQUIREMENTS FOR ADDITIONAL SUPPLEMENTAL PAYMENTS
FOR NURSING FACILITY PROVIDERS
, AND, IN CONNECTION THEREWITH,
MAKING AN APPROPRIATION.
Be it enacted by the General Assembly of the State of Colorado:
SECTION 1. In Colorado Revised Statutes, add 25.5-6-210 as
follows:
25.5-6-210. Additional supplemental payments - nursing
facilities - funding methodology - reporting requirement - rules -
repeal. (1) N
OTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE
CONTRARY AND SUBJECT TO AVAILABLE APPROPRIATIONS
, FOR THE
NOTE: This bill has been prepared for the signatures of the appropriate legislative
officers and the Governor. To determine whether the Governor has signed the bill
or taken other action on it, please consult the legislative status sheet, the legislative
history, or the Session Laws.
________
Capital letters or bold & italic numbers indicate new material added to existing law; dashes
through words or numbers indicate deletions from existing law and such material is not part of
the act. PURPOSES OF REIMBURSING A MEDICAID -CERTIFIED CLASS I NURSING
FACILITY PROVIDER
, THE STATE DEPARTMENT SHALL ISSUE ADDITIONAL
SUPPLEMENTAL PAYMENTS TO NURSING FACILITY PROVIDERS THAT MEET THE
REQUIREMENTS OUTLINED IN THIS SECTION AND THE STATE DEPARTMENT
'S
SUBSEQUENT REGULATION AS FOLLOWS
:
(a) F
OR THE 2021-22 STATE FISCAL YEAR, FUNDS APPROPRIATED BY
THE GENERAL ASSEMBLY ARE FOR THE PURPOSES OF SUPPORTING NURSING
FACILITY PROVIDERS EXPERIENCING INCREASED STAFFING COSTS RESULTING
FROM THE
COVID-19 PANDEMIC, NURSING FACILITY PROVIDERS WITH HIGH
MEDICAID UTILIZATION RATES
, OR NURSING FACILITY PROVIDERS CURRENTLY
SERVING INDIVIDUALS WITH COMPLEX NEEDS
.
(b) P
AYMENTS MADE IN ADDITION TO THOSE SPECIFIED IN
SUBSECTION
(1)(a) OF THIS SECTION MAY ALSO BE MADE TO NURSING
FACILITY PROVIDERS THAT ACCEPT NEW ADMISSIONS OF
MEDICAID
-ENROLLMENT INDIVIDUALS WITH COMPLEX NEEDS .
(2) T
HE STATE DEPARTMENT SHALL ESTABLISH REPORTING AND
RESULT TRACKING REQUIREMENTS NECESSARY TO ADMINISTER THE FUNDING
OUTLINED IN THIS SECTION
. THE STATE DEPARTMENT MAY DENY OR RECOUP
FUNDING FROM NURSING FACILITY PROVIDERS THAT ARE NONCOMPLIANT
WITH REPORTING REQUIREMENTS OR IF FUNDING IS USED FOR PURPOSES
OUTSIDE THE INTENT OF SUPPORTING AND STABILIZING NURSING FACILITY
PROVIDERS THAT ARE MEDICAID PROVIDERS
.
(3) T
HE STATE DEPARTMENT SHALL EVALUATE PROVIDER OUTCOMES ,
INCLUDING CHANGES IN CAPACITY , ASSOCIATED WITH THE PAYMENT OF
SUPPLEMENTAL MONEY TO NURSING FACILITY PROVIDERS
. THE STATE
DEPARTMENT SHALL UTILIZE NURSING FACILITY PROVIDERS
' FINANCIAL
STATEMENTS AND LABOR AND WAGE RECORDS TO EVALUATE THE RESULTS
OF PAYMENTS
.
(4) (a) T
HE STATE DEPARTMENT SHALL PURSUE FEDERAL MATCHING
FUNDS
. IF FEDERAL MATCHING FUNDS ARE UNAVAILABLE FOR ANY REASON ,
PAYMENTS OUTLINED IN THIS SECTION MAY BE REDUCED OR RESTRICTED ,
SUBJECT TO AVAILABLE FUNDING.
(b) F
OR THE PURPOSES OF FEDERAL UPPER PAYMENT LIMIT
CALCULATIONS
, THE STATE DEPARTMENT SHALL PURSUE FEDERAL MATCHING
PAGE 2-HOUSE BILL 22-1247 FUNDS FOR PAYMENTS MADE PURSUANT TO THIS SECTION BUT ONLY AFTER
SECURING FEDERAL MATCHING FUNDS FOR PAYMENTS OUTLINED IN SECTIONS
25.5-6-203 (2) AND 25.5-6-208.
(5) (a) S
UPPLEMENTAL PAYMENTS MADE TO NURSING FACILITY
PROVIDERS PURSUANT TO THIS SECTION MUST BE D ETERMINED BASED ON THE
MOST RECENT AVAILABLE DATA
.
(b) P
URSUANT TO RULES PROMULGATED BY THE STATE DEPARTMENT ,
PAYMENTS RECEIVED PURSUANT TO THIS SECTION MUST BE REPORTED AS
REVENUE ON THE ANNUAL COST REPORT WHEN CALCULATING NURSING
FACILITY PROVIDER PER DIEM REIMBURSEMENT AS DIRECTED BY THE STATE
DEPARTMENT
.
(6) T
O RECEIVE AN ADDITIONAL PAYMENT PURS UANT TO SUBSECTION
(1)(b) OF THIS SECTION, A NURSING FACILITY PROVIDER SHALL WORK WITH
A HOSPITAL TO FACILITATE THE TIMELY DISCHARGE OF MEDICAID MEMBERS
FROM THE HOSPITAL INTO THE NURSING FACILITY
, SERVE MEDICAID
MEMBERS WITH COMPLEX NEEDS
, OR ACCEPT COMPASSIONATE RELEASE
INDIVIDUALS FROM THE DEPARTMENT OF CORRECTIONS
.
(7) O
N OR BEFORE NOVEMBER 1, 2022, THE STATE DEPARTMENT
SHALL ENGAGE WITH STAKEHOLDERS AND SUBMIT A REPORT AND
RECOMMENDATIONS TO THE JOINT BUDGET COMMITTEE
, THE HEALTH AND
HUMAN SERVICES COMMITTEE OF THE SENATE
, AND THE PUBLIC AND
BEHAVIORAL HEALTH AND HUMAN SERV ICES COMMITTEE OF THE HOUSE OF
REPRESENTATIVES
, OR ANY SUCCESSOR COMMITTEES , CONCERNING
SUGGESTED CHANGES FOR PERMANENTLY CHANGING MEDICAID NURSING
FACILITY PROVIDER REIMBURSEMENT POLICY IN
COLORADO TO PRIORITIZE
QUALITY
, SUSTAINABILITY, AND SOUND FISCAL STEWARDSHIP TO AVOID
FURTHER ONE
-TIME CASH INFUSIONS. THE REPORT MUST INCLUDE CHANGES
THAT CAN BE MADE TO AFFIRM A NURSING FACILITY PROVIDER
'S
COMMITMENT TO ACCOUNTABILITY AND MUST INCLUDE
, AT A MINIMUM:
(a) I
NFECTION CONTROL AND CULTURE CHANGE PRACTICES ,
INCLUDING:
(I) S
INGLE OCCUPANCY ROOMS ;
(II) S
MALLER FACILITY MODELS; AND
PAGE 3-HOUSE BILL 22-1247 (III) INNOVATIVE FACILITY MODELS;
(b) B
EHAVIORAL HEALTH NEEDS ;
(c) P
RACTICES REGARDING INDIVIDUALS WHO HAVE COMPLEX NEEDS
REQUIRING HOSPITAL DISCHARGE
;
(d) P
RACTICES REGARDING CARE AND SERVICES TO COMPASSIONATE
RELEASE INDIVIDUALS FROM THE DEPARTMENT OF CORRECTIONS
;
(e) O
PTIONS FOR DIVERSIFIED FUNDING STREAMS TO ENSURE
CONTINUITY OF SERVICES
;
(f) C
OMPETITIVE STAFFING PRACTICES;
(g) T
HE TIMELINE AND COSTS ASSOCIATED WITH IMPLEMENTING THE
RECOMMENDED CHANGES
, INCLUDING THE IMPACT ON NURSING FACILITY
PROVIDER RATES
; AND
(h) IDENTIFICATION OF THE AMOUNT OF SUPPLEMENTAL PAYMENTS
TO EACH NURSING FACILITY PROVIDER AND THE OUTCOME EVALUATION
REQUIRED PURSUANT TO SUBSECTION
(3) OF THIS SECTION.
(8) T
HE STATE DEPARTMENT SHALL MEET WITH THE FOLLOWING
STAKEHOLDERS
, AT A MINIMUM, TO SEEK INPUT ON ANY PROPOSED
REIMBURSEMENT METHODOLOGY CHANGES AND REPORT AS REQUIRED BY
THIS SECTION
:
(a) A
REPRESENTATIVE FROM AN URBAN NURSING FACILITY
PROVIDER
;
(b) A
REPRESENTATIVE FROM A RURAL NURSING FACILITY PROVIDER ;
(c) A
REPRESENTATIVE FROM A NURSING FACILITY TRADE
ORGANIZATION
;
(d) A
REPRESENTATIVE FROM A NURSING FACILITY WITH A HIGH
MEDICAID UTILIZATION RATE
; AND
(e) A REPRESENTATIVE FROM A NURSING FACILITY THAT SERVES
PAGE 4-HOUSE BILL 22-1247 INDIVIDUALS WITH COMPLEX NEEDS .
(9) T
HE STATE BOARD SHALL PROMULGATE ANY RULES NECESSARY
TO IMPLEMENT THIS SECTION
.
(10) T
HIS SECTION IS REPEALED, EFFECTIVE JULY 1, 2023.
SECTION 2. Appropriation. (1) For the 2021-22 state fiscal year,
$17,000,500 is appropriated to the department of health care policy and
financing for use by medical services premiums. This appropriation is from
the general fund and is subject to the "(M)" notation as defined in the
annual general appropriation act for the same fiscal year. To implement this
act, the department may use this appropriation for medical and long-term
care services for Medicaid-eligible individuals.
(2) For the 2021-22 state fiscal year, the general assembly
anticipates that the department of health care policy and financing will
receive $10,000,500 in federal funds to implement this act. The
appropriation in subsection (1) of this section is based on the assumption
that the department will receive this amount of federal funds to be used for
medical and long-term care services for Medicaid-eligible individuals.
(3) Any money appropriated in subsection (1) of this section not
expended prior to July 1, 2022, is further appropriated to the department for
the 2022-23 state fiscal year for the same purpose.
SECTION 3. Safety clause. The general assembly hereby finds,
PAGE 5-HOUSE BILL 22-1247 determines, and declares that this act is necessary for the immediate
preservation of the public peace, health, or safety.
____________________________ ____________________________
Alec Garnett Steve Fenberg
SPEAKER OF THE HOUSE PRESIDENT OF
OF REPRESENTATIVES THE SENATE
____________________________ ____________________________
Robin Jones Cindi L. Markwell
CHIEF CLERK OF THE HOUSE SECRETARY OF
OF REPRESENTATIVES THE SENATE
APPROVED________________________________________
(Date and Time)
_________________________________________
Jared S. Polis
GOVERNOR OF THE STATE OF COLORADO
PAGE 6-HOUSE BILL 22-1247