Health care; Medicaid; nursing facilities; FMAP payments; effective date.
Impact
If enacted, HB2119 would lead to significant changes in how nursing facilities are paid through Medicaid, incentivizing them to enhance their services quality. The bill requires a deduction from each nursing facility's reimbursement rate to fund the quality assurance component, complemented by additional payments from the Authority when specific metrics are met. This could lead to improved care standards across facilities as they strive to meet the outlined performance measures, potentially influencing the overall quality of long-term care in the state.
Summary
House Bill 2119 amends the Oklahoma Medicaid reimbursement policies for nursing facilities, specifically regarding the incentive reimbursement rate plan aimed at improving resident outcomes and the quality of life for residents. The bill mandates the Oklahoma Health Care Authority to develop this incentive plan, which involves a structure where nursing facilities can earn additional payments based on their achievements in specific quality metrics. It emphasizes a pay-for-performance approach, aligning incentive payments with long-stay quality measures defined by the Centers for Medicare and Medicaid Services (CMS). The bill is set to take effect on November 1, 2021.
Sentiment
The sentiment surrounding HB2119 appears to be generally positive among healthcare advocates and providers, as it could enhance care for residents in nursing facilities. Supporters of the bill argue that tying reimbursements to quality outcomes will promote better patient care and improve living conditions for residents. However, there could be concerns from some stakeholders regarding the feasibility of meeting the quality metrics and the financial implications for facilities at risk of not meeting performance benchmarks.
Contention
Notable points of contention around HB2119 may relate to the funding mechanism for the quality improvement program and the potential pressure it places on nursing facilities, particularly those already struggling financially. Critics might argue that the performance measures could be overly ambitious or not account for disparities in resources among facilities. Additionally, there could be debates regarding how the quality metrics are determined and the accountability of the Oklahoma Health Care Authority in managing and auditing this new reimbursement plan.
State Medicaid program; directing Health Care Authority to enter into capitated contracts to transform Medicaid delivery system for certain Medicaid populations; modifying various provisions of the Ensuring Access to Medicaid Act; repealers. Effective date. Emergency. Conditional effect.
Public health; Oklahoma State University Medical Authority; Medicaid supplemental payments; agreements and contract; benefits; waivers; creating the Emergency Medicine Revolving Fund; effective date.