Louisiana House Bill HB461

Louisiana 2018 Regular Session

• Introduced: 3/1/18
• Refer: 3/2/18
• Refer: 3/12/18

Caption

Provides relative to Medicaid financing of nursing home care (OR SEE FISC NOTE GF EX)

Impact

The implementation of HB 461 represents a move away from the previously used systems for calculating Medicaid reimbursements based on historical costs. By establishing a new prospective payment system, the law intends to offer more predictable funding levels for nursing homes while ensuring that quality care remains a priority. Additionally, the repeal of outdated provisions regarding resource allocation models signifies a broader overhaul of how Medicaid funds are distributed among long-term care providers, which may lead to a more equitable and effective allocation of resources.

Summary

House Bill 461 introduces significant changes to the Medicaid financing structure for nursing home care in Louisiana. The bill mandates that the Louisiana Department of Health (LDH) establish a reimbursement rate methodology that is prospective and takes into account the actual costs reflected in audited reports from nursing facilities. This shift aims to ensure that the primary focus of the Medicaid funding is on direct care, thereby promoting quality of care in nursing homes. Moreover, the bill stipulates the creation of a component in the funding formula linked to the achievement of quality outcomes, thereby incentivizing facilities to improve standards.

Sentiment

The sentiment among stakeholders regarding HB 461 appears to be cautiously optimistic. Proponents of the bill, including nursing home administrators and patient advocates, see it as a necessary reform that prioritizes both the care of residents and the sustainability of nursing home operations. However, there are concerns among certain healthcare advocates that the changes might not fully address the complexities of individual nursing home operations or adequately account for varying levels of resident acuity, which could impact care quality if not properly implemented.

Contention

Notable points of contention surrounding HB 461 focus on the concerns that the new reimbursement methodology may not adequately consider the diverse needs of nursing home residents. Critics worry that the exclusion of Medicare and other funding sources in the acuity calculations might result in underfunding for homes serving higher acuity residents, thereby affecting the level of care provided. The debate emphasizes the balance that must be struck between standardized funding methods and the need for flexibility to address the unique challenges faced by different facilities across the state.