First Regular Session
Seventy-fourth General Assembly
STATE OF COLORADO
ENGROSSED
This Version Includes All Amendments Adopted
on Second Reading in the House of Introduction
LLS NO. 23-0700.01 Shelby Ross x4510
HOUSE BILL 23-1228
House Committees Senate Committees
Public & Behavioral Health & Human Services
Finance
Appropriations
A BILL FOR AN ACT
C
ONCERNING NURSING FACILITY REIMBURSEMENT RATE
SETTING, AND,101
IN CONNECTION THEREWITH , MAKING AN APPROPRIATION .102
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
.)
The bill adjusts the supplemental medicaid payment rates a
qualifying nursing facility receives from the department of health care
policy and financing (state department).
Current law limits the annual increase of the general fund share of
the aggregate statewide average of the per diem rate to not more than 3%.
The bill removes this limitation and requires the general fund share be
HOUSE
Amended 2nd Reading
April 14, 2023
HOUSE SPONSORSHIP
McCluskie and Willford,
SENATE SPONSORSHIP
Zenzinger and Smallwood,
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law. calculated based on specific percentage increases.
The bill requires the state department to initiate a process no later
than July 1, 2023, to remove the medicare costs from the provider rate
setting by July 1, 2026.
The bill repeals the requirement that only such costs as are
reasonable, necessary, and patient-related be reported for reimbursement
purposes.
The bill authorizes the state department to require a nursing
facility, as a condition of receiving medicaid funds, to submit any
documentation necessary to ensure the state's interest in transparency,
stability, and sound fiscal stewardship.
As part of developing and implementing a transition plan to
regulate nursing facility reimbursement, the bill requires the state
department to:
! No later than July 1, 2026, define "nursing home
reimbursement" and provide payments to nursing facilities;
! Engage with stakeholders regularly to seek input on any
proposed methodology changes; and
! From November 1, 2023, to November 1, 2026, submit an
annual report to the joint budget committee of the general
assembly regarding the implementation process.
The bill requires the state department to issue additional
supplemental payments to nursing facility providers with
disproportionately high medicaid utilization, to facilities that are
geographically critical to ensuring access to care, and to facilities that
admit compassionate release individuals from the department of
corrections.
Effective July 1, 2026, the bill repeals:
! The requirement that the state department exempt certain
nursing facility providers from the provider fee;
! The process for providing a wage enhancement
supplemental payment to eligible nursing home providers
that pay their employees a wage of at least $15 per hour;
and
! Requirements for issuing additional supplemental payments
to nursing facility providers that meet certain requirements.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 25.5-6-202, amend2
(5), (6), (9)(b)(I), and (9)(c)(I); repeal (9)(c)(II); and add (9)(b)(I.5),3
(13), (14),
(15), and (16) as follows:4
1228-2- 25.5-6-202. Providers - nursing facility provider1
reimbursement - exemption - rules - repeal. (5) Subject to available2
moneys APPROPRIATIONS and the priority of the uses of the provider fees3
as established in section 25.5-6-203 (2)(b), in addition to the4
reimbursement rate components paid pursuant to subsections (1) to (4) of5
this section, the state department shall make a supplemental medicaid6
payment based upon performance to those nursing facility providers that7
provide services that result in better care and higher quality of life for8
their residents. This amount shall be determined by The state department9
SHALL DETERMINE THE PAYMENT AMOUNT based upon performance10
measures established in rules adopted by the state board in the domains11
of quality of life, quality of care, and facility management. The payment12
shall be computed annually as of July 1, 2009, and each July 1 thereafter,13
and shall not be less than twenty-five hundredths of one percent of the14
statewide average per diem rate for the combined rate components15
determined pursuant to subsections (1) to (4) of this section. BEGINNING16
J
ULY 1,
2024, THE PAYMENT MUST NOT BE LESS THAN TWELVE PERCENT OF17
TOTAL PROVIDER FEE PAYMENTS AND MUST BE ADJUSTED FOR FISCAL18
YEARS 2024-25 AND 2025-26. NO LATER THAN JULY 1, 2026, THE19
PAYMENT MUST NOT BE LESS THAN FIFTEEN PERCENT OF TOTAL PROVIDER20
FEE PAYMENTS AND MUST BE ANNUALLY ADJUSTED THEREAFTER. During21
each state fiscal year, the state department may discontinue the22
supplemental medicaid payment established pursuant to this subsection23
(5) to any nursing facility provider that fails to comply with the24
established performance measures during the state fiscal year, and the25
state department may initiate the supplemental medicaid payment26
established pursuant to this subsection (5) to any provider who THAT27
1228
-3- comes into compliance with the established performance measures during1
the state fiscal year.2
(6) Subject to available money APPROPRIATIONS and the priority3
of the uses of the provider fees as established in section 25.5-6-2034
(2)(b), in addition to the reimbursement rate components
PAID pursuant5
to subsections (1) to (5) of this section, the state department shall make6
a supplemental medicaid payment to nursing facility providers that have
7
SERVE residents: who have moderately to very severe mental health8
conditions, dementia diseases and related disabilities, or acquired brain9
injury as follows:10
(a) A supplemental medicaid payment shall be made to nursing11
facility providers that serve residents Who have severe mental health12
conditions that are classified at a level II by the medicaid program's13
preadmission screening and resident review assessment tool. The state14
department shall compute this payment annually as of July 1, 2009, and15
each July 1 thereafter, and it shall be MUST not BE less than two percent16
of the statewide average per diem rate for the combined rate components17
determined pursuant to subsections (1) to (4) of this section. B
EGINNING18
J
ULY 1, 2023, THE STATE DEPARTMENT SHALL ANNUALLY ADJUST THE19
RATE TO ENSURE ACCESS TO CARE FOR RESIDENTS WHO HAVE SEVERE20
MENTAL HEALTH CONDITIONS .21
(b) A supplemental medicaid payment shall be made to nursing
22
facility providers that serve residents With severe dementia diseases and23
related disabilities or acquired brain injury. The state department shall24
calculate the payment based upon the resident's cognitive assessment25
established in rules adopted by the state board. The state department shall26
compute this payment annually as of July 1, 2009, and each July 127
1228
-4- thereafter, and it shall be MUST not BE less than one percent of the1
statewide average per diem rate for the combined rate components2
determined under PURSUANT TO subsections (1) to (4) of this section.3
B
EGINNING JULY 1, 2023, THE STATE DEPARTMENT SHALL ANNUALLY4
ADJUST THE RATE TO ENSURE ACCESS TO CARE FOR RESIDENTS WITH5
SEVERE DEMENTIA DISEASES AND RELATED DISABILITIES OR ACQUIRED6
BRAIN INJURY.7
(9) (b) (I) Except for changes in the number of patient days,
THE8
STATE DEPARTMENT SHALL ESTABLISH the general fund share of the9
aggregate statewide average of the per diem rate net of patient payment10
pursuant to subsections (1) to (4) of this section. shall be limited to an
11
annual increase of three percent The state's share of the reimbursement12
rate components pursuant to subsections (1) to (4) of this section may be13
funded through the provider fee assessed pursuant to the provisions of14
section 25.5-6-203 and any associated federal funds. Any provider fee15
used as the state's share and all federal funds shall MUST be excluded from16
the calculation of the general fund limitation on the annual increase17
SHARE. For the fiscal year commencing July 1, 2009, and for each fiscal18
year thereafter,
THE STATE DEPARTMENT SHALL CALCULATE the general19
fund share of the aggregate statewide average per diem rate net of patient20
payment pursuant to subsections (1) to (4) of this section shall be
21
calculated using the rates that were effective on July 1 of that fiscal year;22
EXCEPT THAT:23
(A) F
OR FISCAL YEAR 2023-24, THE STATE DEPARTMENT SHALL24
INCREASE THE AGGREGATE STATEWIDE AVERAGE OF THE PER DIEM RATE25
BY AT LEAST TEN PERCENT;26
(B) F
OR FISCAL YEAR 2024-25, THE STATE DEPARTMENT SHALL27
1228
-5- INCREASE THE AGGREGATE STATEWIDE AVERAGE OF THE PER DIEM RATE1
BY AT LEAST THREE PERCENT;2
(C) F
OR FISCAL YEAR 2025-26, THE STATE DEPARTMENT SHALL3
INCREASE THE AGGREGATE STATEWIDE AVERAGE OF THE PER DIEM RATE4
BY AT LEAST ONE AND ONE-HALF PERCENT; AND5
(D) B
EGINNING IN FISCAL YEAR 2026-27, AND FOR EACH FISCAL6
YEAR THEREAFTER, THE STATE DEPARTMENT SHALL ESTABLISH THE7
AGGREGATE STATEWIDE AVERAGE OF THE PER DIEM RATE .8
(I.5) W
HEN INCREASING THE AGGREGATE STATEWIDE AVERAGE OF9
THE PER DIEM RATE FOR FISCAL YEARS 2023 THROUGH 2027, THE10
REIMBURSEMENT RATE FOR A CLASS I NURSING FACILITY THAT OPERATES11
EFFICIENTLY AND ECONOMICALLY MUST BE REASONABLE AND ADEQUATE12
TO MEET THE NURSING HOME 'S COSTS IN ORDER TO PROVIDE CARE AND13
SERVICES IN CONFORMITY WITH APPLICABLE STATE AND FEDERAL LAWS ,14
REGULATIONS, AND QUALITY AND SAFETY STANDARDS , AND MUST BE15
BASED ON THE MOST RECENT AUDITED AND FINALIZED COST AND16
UTILIZATION DATA AVAILABLE.17
(c) (I) The general assembly finds that the historical growth in18
nursing facility provider rates has significantly exceeded the rate of19
inflation. These increases have been caused in part by the inclusion of20
medicare costs in medicaid cost reports. The state of Colorado has an21
interest in limiting these exceptional increases in medicaid nursing facility22
provider rates by removing medicare part B direct
costs from the23
medicaid nursing facility provider rates and by imposing a ceiling on the24
medicare part A ancillary costs that are included in calculating medicaid25
nursing facility rates. N
O LATER THAN JULY 1, 2023, THE STATE26
DEPARTMENT SHALL INITIATE A PROCESS TO REMOVE MEDICARE COSTS27
1228
-6- FROM THE PROVIDER RATE SETTING BY JULY 1, 2026. THE STATE BOARD1
SHALL PROMULGATE RULES ESTABLISHING THE SPECIFIC METHODOLOGY2
USED FOR REMOVING MEDICARE COSTS .3
(II) For all rates effective on or after July 1, 1997, for each class4
I nursing facility provider, only such costs as are reasonable, necessary,5
and patient-related may be reported for reimbursement purposes. Nursing6
facility providers may include the level of medicare part A ancillary costs7
that was included and allowed in the facility's last medicaid cost report8
filed prior to July 1, 1997. Any subsequent increase in this amount shall9
be limited to either the increase in the facility's allowable medicare part10
A ancillary costs or the percentage increase in the cost of medical care11
reported in the United States department of labor bureau of labor statistics12
consumer price index for the same time period, whichever is lower. Part13
B direct costs for medicare shall be excluded from the allowable14
reimbursement for facilities.15
(13) (a) A
S A CONDITION OF RECEIVING MEDICAID FUNDS , THE16
STATE DEPARTMENT MAY REQUIRE A NURSING FACILITY TO SUBMIT ANY17
DOCUMENTATION NECESSARY TO ENSURE THE STATE 'S INTEREST IN18
TRANSPARENCY, STABILITY, AND SOUND FISCAL STEWARDSHIP ,19
INCLUDING, BUT NOT LIMITED TO:20
(I) A
NNUAL AUDITED FINANCIAL STATEMENTS , PREPARED BY AN21
INDEPENDENT ACCOUNTANT , FOR A FACILITY, MANAGEMENT COMPANY ,22
AND ANY RELATED PARTY C ONDUCTING BUSINESS WITH A23
MEDICAID-CERTIFIED NURSING FACILITY , INCLUDING AUDITED AND24
CONSOLIDATED FINANCIAL STATEMENTS FOR ANY PARENT COMPANY THAT25
ACCEPTS, OR WHOSE SUBSIDIARIES ACCEPT, MEDICAID PAYMENTS FROM26
THE STATE OF COLORADO;27
1228
-7- (II) DETAILS ON TRANSACTIONS BETWEEN RELATED PARTIES OR1
ENTITIES THAT HAVE COMMON OWNERSHIP ; AND2
(III) O
WNERSHIP INTEREST IN REAL ESTATE , MANAGEMENT3
COMPANIES, FACILITY OPERATORS, AND ALL RELATED PARTIES.4
(b) T
HE STATE DEPARTMENT SHALL DETERMINE THE FORMAT FOR5
THE DOCUMENTATION PROVIDED BY EACH NURSING FACILITY .6
(c) T
HE STATE BOARD SHALL ESTABLISH BY RULE ANY PENALTIES7
FOR NONCOMPLIANCE WITH THE FINANCIAL REPORTING REQUIRED8
PURSUANT TO THIS SUBSECTION (13).9
(d) T
HE COSTS ASSOCIATED WITH THE FINANCIAL REPORTING10
REQUIRED PURSUANT TO THIS SUBSECTION (13), INCLUDING ANY AUDIT11
COSTS INCURRED BY A NURSING FACILITY , ARE AN ALLOWABLE EXPENSE12
ON THE MEDICAID COST REPORT AND MUST BE INCORPORATED AS A13
COMPONENT OF THE OVERALL REIMBURSEMENT METHODOLOGY .14
(14) T
HE GENERAL ASSEMBLY FINDS THAT THE INFLEXIBLE15
NATURE OF STATUTORILY FIXED REIMBURSEMENT RATES IS NOT IN THE16
BEST INTEREST OF THE STATE OF COLORADO. THEREFORE, THE STATE17
DEPARTMENT SHALL DEVELOP AND IMPLEMENT A TRANSITION PLAN TO18
REGULATE NURSING FACILITY REIMBURSEMENT AIMED AT IMPROVING THE19
HEALTH AND SAFETY OF RESIDENTS , PROMOTING INNOVATION AND20
IMPROVED INFECTION CONTROL EFFORTS , IMPROVING ACCESS TO CARE,21
AND PROMOTING INNOVATION IN COLORADO NURSING FACILITIES. AS PART22
OF THIS PROCESS, THE STATE DEPARTMENT SHALL :23
(a) N
O LATER THAN JULY 1, 2026, DEFINE "NURSING HOME24
REIMBURSEMENT" THROUGH RULES PROMULGATED BY THE STATE BOARD25
AND PROVIDE PAYMENTS TO NURSING FACILITIES CONSISTENT WITH THE26
PROMULGATED RULES;27
1228
-8- (b) ENGAGE WITH STAKEHOLDERS REGULARLY TO SEEK INPUT ON1
ANY PROPOSED METHODOLOGY CHANGES AND ENSURE THE METHODOLOGY2
IS REASONABLE AND ADEQUATE TO MEET THE COSTS OF AN EFFICIENTLY3
AND ECONOMICALLY OPERATED NURSING FACILITY THAT PROVIDES CARE4
AND SERVICES IN CONFORMITY WITH APPLICABLE STATE AND FEDERAL5
LAWS, REGULATIONS, AND QUALITY AND SAFETY STANDARDS BASED ON6
THE MOST RECENT AUDIT AND FINALIZED COST AND UTILIZATION DATA7
AVAILABLE; AND8
(c) F
ROM NOVEMBER 1, 2023, TO NOVEMBER 1, 2026, SUBMIT AN9
ANNUAL REPORT TO THE JOINT B UDGET COMMITTEE OF THE GENERAL10
ASSEMBLY REGARDING THE IMPLEMENTATION PROGRESS DESCRIBED IN11
THIS SUBSECTION (14), INCLUDING, AT A MINIMUM:12
(I) R
ECORDS OF STAKEHOLDER ENGAGEMENT ;13
(II) C
ONCLUSIONS DRAWN FROM FINANCIAL OVERSIGHT14
ACTIVITIES;15
(III) I
SSUES REGARDING PAYMENT EQUITY AND ACCESS TO CARE16
COORDINATION; AND17
(IV) E
XPECTED BUDGETARY IMPACTS OF ANY METHODOLOGY18
CHANGE.19
(15) (a) EACH NURSING FACILITY THAT RECEIVES MEDICAID FUNDS20
SHALL DEVELOP AND SUBMIT A PLAN TO THE STATE DEPARTMENT THAT21
MEETS STATE DEPARTMENT STANDARDS AND DEMONSTRATES HOW THE22
NURSING FACILITY WILL:23
(I) IMPROVE THE HEALTH AND SAFETY OF THE NURSING FACILITY'S24
RESIDENTS, INCLUDING INFECTION CONTROL AND STAFFING ;25
(II) INCREASE ACCESS TO CARE;26
(III) IMPROVE FINANCIAL SUSTAINABILITY, INCLUDING27
1228
-9- OPPORTUNITIES FOR DIVERSIFICATION OF BUSINESS LINES AND1
STABILIZATION OF REVENUE STREAMS ; AND2
(IV) PROMOTE INNOVATION TO MEET THE EMERGING NEEDS OF3
INDIVIDUALS WITH DISABILITIES AND AGING AND OLDER ADULTS .4
(b) THE STATE BOARD SHALL PROMULGATE RULES IMPLEMENTING5
THIS SUBSECTION (15).6
(16) SUBSECTIONS 1 TO 9 OF THIS SECTION AND THIS SUBSECTION7
(16) ARE REPEALED, EFFECTIVE JULY 1, 2026.8
SECTION 2. In Colorado Revised Statutes, 25.5-6-203, amend9
(1)(c) as follows:10
25.5-6-203. Nursing facilities - provider fees - federal waiver11
- fund created - rules - repeal. (1) (c) (I) In accordance with the12
redistributive method set forth in 42 CFR 433.68 (e)(1) and (e)(2), the13
state department shall seek a waiver from the broad-based provider fees14
requirement or the uniform provider fees requirement, or both, to exclude15
nursing facility providers from the provider fee. The state department16
shall exempt the following nursing facility providers to obtain federal17
approval and minimize the financial impact on nursing facility providers:18
(I) (A) A facility operated as a continuing care retirement19
community that provides a continuum of services by one operational20
entity providing independent living services, assisted living services, and21
skilled nursing care on a single, contiguous campus. Assisted living22
services include an assisted living residence as defined in section23
25-27-102 C.R.S., or that provides assisted living services on-site,24
twenty-four hours per day, seven days per week.25
(II) (B) A skilled nursing facility owned and operated by the state;26
(III) (C) A nursing facility that is a distinct part of a facility that27
1228
-10- is licensed as a general acute care hospital; and1
(IV) (D) A facility that has forty-five or fewer licensed beds.2
(II) NO LATER THAN JULY 1, 2026, THE STATE DEPARTMENT SHALL3
PROMULGATE RULES MAINTAINING THE EXEMPTIONS IDENTIFIED IN THIS4
SUBSECTION (1)(c) IN ORDER TO MINIMIZE THE FINANCIAL IMPACT ON5
NURSING FACILITY PROVIDERS.6
(III) THIS SUBSECTION (1)(c) IS REPEALED, EFFECTIVE JULY 1,7
2028.8
SECTION 3. In Colorado Revised Statutes, 25.5-6-208, add (7)9
as follows:10
25.5-6-208. Nursing facility provider reimbursement - rules -11
definition - repeal. (7) T
HIS SECTION IS REPEALED, EFFECTIVE JULY 1,12
2026.13
SECTION 4. In Colorado Revised Statutes, 25.5-6-210, amend14
(10); repeal (1)(a), (1)(b), (6), (7), (8), and (9); and add (1)(c) and (1)(d)15
as follows:16
25.5-6-210. Additional supplemental payments - nursing17
facilities - funding methodology - reporting requirement - rules -18
repeal. (1) Notwithstanding any other provision of law to the contrary19
and subject to available appropriations, for the purposes of reimbursing20
a medicaid-certified class I nursing facility provider, the state department21
shall issue additional supplemental payments to nursing facility providers22
that meet the requirements outlined in this section and the state23
department's subsequent regulation as follows:24
(a) For the 2021-22 state fiscal year, funds appropriated by the
25
general assembly are for the purposes of supporting nursing facility26
providers experiencing increased staffing costs resulting from the27
1228
-11- COVID-19 pandemic, nursing facility providers with high medicaid1
utilization rates, or nursing facility providers currently serving individuals2
with complex needs.3
(b) Payments made in addition to those specified in subsection4
(1)(a) of this section may also be made to nursing facility providers that5
accept new admissions of medicaid-enrollment individuals with complex6
needs.7
(c) A
PAYMENT TO A NURSING FACILITY WITH8
DISPROPORTIONATELY HIGH MEDICAID UTILIZATION OR GEOGRAPHICALLY9
CRITICAL TO ENSURING ACCESS TO CARE . IN DETERMINING QUALIFYING10
FACILITIES FOR THIS PAYMENT, THE STATE DEPARTMENT SHALL CONSIDER11
ANY ACCESS TO CARE IMPACTS TO INDIVIDUALS NOT COVERED BY12
MEDICAID, INCLUDING, BUT NOT LIMITED TO, VETERANS ADMINISTRATION13
BENEFICIARIES, INDIVIDUALS WITHOUT HEALTH -CARE COVERAGE, AND14
INDIVIDUALS PENDING MEDICAID COVERAGE .15
(d) A
PAYMENT TO A NURSING FACILITY ADMITTING16
COMPASSIONATE RELEASE INDIVIDUALS FROM THE DEPARTMENT OF17
CORRECTIONS WHO NEED ADDITIONAL SERVICES TO ENSURE ACCESS TO18
CARE.19
(6) To receive an additional payment pursuant to subsection (1)(b)
20
of this section, a nursing facility provider shall work with a hospital to21
facilitate the timely discharge of medicaid members from the hospital into22
the nursing facility, serve medicaid members with complex needs, or23
accept compassionate release individuals from the department of24
corrections.25
(7) On or before November 1, 2022, the state department shall26
engage with stakeholders and submit a report and recommendations to the27
1228
-12- joint budget committee, the health and human services committee of the1
senate, and the public and behavioral health and human services2
committee of the house of representatives, or any successor committees,3
concerning suggested changes for permanently changing medicaid4
nursing facility provider reimbursement policy in Colorado to prioritize5
quality, sustainability, and sound fiscal stewardship to avoid further6
one-time cash infusions. The report must include changes that can be7
made to affirm a nursing facility provider's commitment to accountability8
and must include, at a minimum:9
(a) Infection control and culture change practices, including:10
(I) Single occupancy rooms;11
(II) Smaller facility models; and12
(III) Innovative facility models;13
(b) Behavioral health needs;14
(c) Practices regarding individuals who have complex needs15
requiring hospital discharge;16
(d) Practices regarding care and services to compassionate release17
individuals from the department of corrections;18
(e) Options for diversified funding streams to ensure continuity of19
services;20
(f) Competitive staffing practices;21
(g) The timeline and costs associated with implementing the22
recommended changes, including the impact on nursing facility provider23
rates; and24
(h) Identification of the amount of supplemental payments to each25
nursing facility provider and the outcome evaluation required pursuant to26
subsection (3) of this section.27
1228
-13- (8) The state department shall meet with the following1
stakeholders, at a minimum, to seek input on any proposed reimbursement2
methodology changes and report as required by this section:3
(a) A representative from an urban nursing facility provider;4
(b) A representative from a rural nursing facility provider;5
(c) A representative from a nursing facility trade organization;6
(d) A representative from a nursing facility with a high medicaid7
utilization rate; and8
(e) A representative from a nursing facility that serves individuals9
with complex needs.10
(9) The state board shall promulgate any rules necessary to11
implement this section.12
(10) This section is repealed, effective July 1, 2023 2026.13
SECTION 5. In Colorado Revised Statutes, 25-48-102, amend14
(4) as follows:15
25-48-102. Definitions. As used in this article 48, unless the16
context otherwise requires:17
(4) "Health-care provider" or "provider" means a person who is18
licensed, certified, registered, or otherwise authorized or permitted by law19
to administer health care or dispense medication in the ordinary course of20
business or practice of a profession. The term includes a health-care21
facility, including a long-term care facility as defined in section22
25-3-103.7 (1)(f.3) and a continuing care retirement community as23
described in section 25.5-6-203 (1)(c)(I), C.R.S. (1)(c)(I)(A).24
SECTION 6. Appropriation. (1) For the 2023-24 state fiscal25
year, $30,509,457 is appropriated to the department of health care policy26
and financing. This appropriation is from the general fund, which is27
1228
-14- subject to the "(M)" notation as defined in the annual general1
appropriation act for the same fiscal year. To implement this act, the2
department may use this appropriation for medical and long-term care3
services for Medicaid eligible individuals.4
(2) For the 2023-24 state fiscal year, the general assembly5
anticipates that the department of health care policy and financing will6
receive $31,754,740 in federal funds for medical and long-term care7
services for Medicaid eligible individuals to implement this act. The8
appropriation in subsection (1) of this section is based on the assumption9
that the department will receive this amount of federal funds.10
SECTION 7. Safety clause. The general assembly hereby finds,11
determines, and declares that this act is necessary for the immediate12
preservation of the public peace, health, or safety.13
1228
-15-