Connecticut House Bill HB05589

Connecticut 2016 Regular Session

• Introduced: 3/3/16
• Refer: 3/3/16

Caption

An Act Concerning An Acuity-based System For Medicaid Reimbursement.

Impact

The introduction of an acuity-based system for Medicaid reimbursement is expected to offer a more equitable and needs-based approach to funding nursing home facilities across the state. By considering various factors, including the costs specific to each county and additional rate adjustments for special needs, the bill aims to ensure that facilities can adequately support their residents. This approach could positively influence the quality of care in nursing homes, particularly for those with higher health needs, by allowing facilities to receive appropriate financial support.

Summary

House Bill 5589 aims to establish an acuity-based methodology for Medicaid reimbursement specifically tailored for nursing home services. The bill mandates the Commissioner of Social Services to develop this methodology based on existing successful systems, including the skilled nursing facility prospective payment system by the Centers for Medicare and Medicaid Services. This new reimbursement structure will utilize a classification system based on residents' conditions and required care resources, which will address the complexities of residents with special needs such as dementia, developmental disabilities, or bariatric conditions. The implementation of the bill is set to commence on July 1, 2016.

Contention

Despite the potential benefits, there may be concerns regarding the transition to this new reimbursement strategy, particularly during the four-year phase-in period stipulated in the bill. Transitioning from existing reimbursement models to an acuity-based one may generate uncertainty among nursing homes regarding funding during the adjustment. Additionally, the power afforded to the Commissioner of Social Services to impose necessary policies while pending regulation adoption has raised questions about oversight and transparency in the implementation process. Stakeholders may be apprehensive about how changes will affect their operations and funding stability.