Texas House Bill HB1816

Texas 2021 - 87th Regular

Caption

Relating to the reimbursement of nursing facilities under Medicaid.

Impact

This legislation is designed to enhance the quality of services rendered by nursing facilities by incentivizing better staffing levels and care standards. For example, the bill includes provisions for incentive programs aimed at rewarding nursing facilities that increase their direct care staff. Additionally, it sets a requirement for managed care organizations to comply with the updated reimbursement rate standards and ensures timely payments to nursing facilities for services rendered. Failure to comply with these regulations could impact the operational funding of nursing facilities, particularly those that depend on Medicaid for their revenue.

Summary

House Bill 1816 focuses on the reimbursement structure for nursing facilities under the Medicaid program in Texas. It amends provisions in the Human Resources Code regarding how the executive commissioner sets rates for nursing facilities. Specifically, the bill mandates that the base rate reimbursement for nursing facilities is maintained at a minimum equivalent to the rate in effect as of April 1, 2020, ensuring that facilities are financially supported during this crucial period. Furthermore, it emphasizes improving the quality of care through potential increases in staff wages and benefits, contingent on available appropriated funds.

Contention

While HB 1816 is largely expected to benefit nursing facilities and their patients through better funding and quality improvements, concerns have been raised regarding the practicality of the funding mechanisms. Critics argue that the reliance on appropriated funds to boost staff wages may not be sustainable or sufficient to meet the needs of all facilities. There is also apprehension about the potential delays in contract amendments with managed care organizations, which may leave some facilities in uncertain financial situations until compliance can be ensured. This bill illustrates the tension between ensuring quality care and the realities of budget constraints in Medicaid funding.