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53	53	STATE OF OKLAHOMA
54	54
55	55	2nd Session of the 59th Legislature (2024)
56	56
57	57	HOUSE BILL 3025 By: Humphrey
58	58
59	59
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63	63	AS INTRODUCED
64	64
65	65	An Act relating to public health and safety; amending
66	66	56 O.S. 2021, Section 2002, which relates to Nursing
67	67	Facilities Quality of Care Fee; terminating fee; and
68	68	providing an effective date.
69	69
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75	75	BE IT ENACTED BY THE PEOPLE OF T HE STATE OF OKLAHOMA:
76	76	SECTION 1. AMENDATORY 56 O.S. 2021, Section 2002, is
77	77	amended to read as follows :
78	78	Section 2002. A. For the purpose of providing quality care
79	79	enhancements, the Oklahoma Health Care Authority is authorized to
80	80	and shall assess a Nursing Facilities Quality of Care Fee pursuant
81	81	to this section upon each nursing facility licensed in this state.
82	82	Facilities operated by the Oklahoma Department of Veterans Affairs
83	83	shall be exempt from this fee. Quality of care enhancements
84	84	include, but are not limited to, the purposes specified in this
85	85	section.
86	86	B. As a basis for determining the Nursing Facilities Quality of
87	87	Care Fee assessed upon each licensed nursing facility, the Au thority
88	88
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139	139	shall calculate a uniform per -patient day rate. The rate shall be
140	140	calculated by dividing six percent (6%) of the total annual patient
141	141	gross receipts of all licensed nursing facilities in this s tate by
142	142	the total number of patient days for all licen sed nursing facilities
143	143	in this state. The result shall be the per -patient day rate.
144	144	Beginning July 15, 2004, the Nursing Facilities Quality of Care Fee
145	145	shall not be increased unless specifically autho rized by the
146	146	Legislature. Effective November 1 , 2026, the Nursing Facilities
147	147	Quality of Care Fee shall be terminated.
148	148	C. Pursuant to any approved Medicaid waiver and pursuant to
149	149	subsection N of this section, the Nursing Facilities Quality of Care
150	150	Fee shall not exceed the amount or rate allowed by federal la w for
151	151	nursing home licensed bed days.
152	152	D. The Nursing Facilities Quality of Care Fee owed by a
153	153	licensed nursing facility shall be calculated by the Authority by
154	154	adding the daily patient census of a lic ensed nursing facility, as
155	155	reported by the facility for each day of the month, and by
156	156	multiplying the ensuing figure by the per -patient day rate
157	157	determined pursuant to the provisions of subsection B of this
158	158	section.
159	159	E. Each licensed nursing facility which is assessed the Nursing
160	160	Facilities Quality of Care Fee shall be required to file a report on
161	161	a monthly basis with the Authority detailing the daily patient
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213	213	census and patient gross receipts at such time and in such manner as
214	214	required by the Authority.
215	215	F. 1. The Nursing Facilities Qualit y of Care Fee for a
216	216	licensed nursing facility for the period beginning October 1, 2000,
217	217	shall be determined using the daily patient census and annual
218	218	patient gross receipts figures reported to the Authority for the
219	219	calendar year 1999 upon forms supplied by the Authority.
220	220	2. Annually the Nursing Facilities Quality of Care Fee shall be
221	221	determined by:
222	222	a. using the daily patient census and patient gross
223	223	receipts reports received by the Authority for the
224	224	most recent available t welve (12) months, and
225	225	b. annualizing those figures.
226	226	Each year thereafter, the annualization of the Nursing
227	227	Facilities Quality of Care Fee specified in this paragraph shall be
228	228	subject to the limitation in subsection B of this section unless the
229	229	provision of subsection C of this section is met.
230	230	G. The payment of the Nursing Facilities Quality of Care Fee by
231	231	licensed nursing facilities shall be an allowable cost for Medicaid
232	232	reimbursement purposes.
233	233	H. 1. There is hereby created in the State Treasury a
234	234	revolving fund to be designated the "Nursing Facility Quali ty of
235	235	Care Fund".
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287	287	2. The fund shall be a continuing fund, not subject to fiscal
288	288	year limitations, and shall consist of:
289	289	a. all monies received by the Authority pursuant to this
290	290	section and otherwise s pecified or authorized by law,
291	291	b. monies received by th e Authority due to federal
292	292	financial participation pursuant to Title XIX of the
293	293	Social Security Act, and
294	294	c. interest attributable to investment of money in the
295	295	fund.
296	296	3. All monies accruing to the cred it of the fund are hereby
297	297	appropriated and shall be bud geted and expended by the Authority
298	298	for:
299	299	a. reimbursement of the additional costs paid to
300	300	Medicaid-certified nursing facilities for purposes
301	301	specified by Sections 1 -1925.2 and 5022.2 of Title 63
302	302	of the Oklahoma Statutes,
303	303	b. reimbursement of the Medicaid ra te increases for
304	304	intermediate care facilities for individuals with
305	305	intellectual disabilities Intermediate Care Facilities
306	306	for Individuals with Intellectual Disabilities
307	307	(ICFs/IID),
308	308	c. nonemergency transportati on services for Medicaid -
309	309	eligible nursing home clients,
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361	361	d. eyeglass and denture services for Medicaid -eligible
362	362	nursing home clients,
363	363	e. fifteen ombudsmen employed by the Department of Human
364	364	Services,
365	365	f. ten additional nursing facility inspectors employed b y
366	366	the State Department of Health,
367	367	g. pharmacy and other Medicaid ser vices to qualified
368	368	Medicare beneficiaries whose incomes are at or below
369	369	one hundred percent (100%) of the federal poverty
370	370	level; provided, however, pharmacy benefits authorized
371	371	for such qualified Medicare beneficiaries shall be
372	372	suspended if the federal gove rnment subsequently
373	373	extends pharmacy benefits to this p opulation,
374	374	h. costs incurred by the Authority in the administration
375	375	of the provisions of this section and any programs
376	376	created pursuant to this section,
377	377	i. durable medical equipme nt and supplies servic es for
378	378	Medicaid-eligible elderly adults, and
379	379	j. personal needs allowance increases for residents of
380	380	nursing homes and Intermediate Care Facilities for
381	381	Individuals with Intellectual Disabi lities (ICFs/IID)
382	382	from Thirty Dollars ($30.00) to Fifty Dollars ($50. 00)
383	383	per month per resident.
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435	435	4. Expenditures from the f und shall be made upon warrants
436	436	issued by the State Treasurer against claims filed as prescribed by
437	437	law with the Director of the Off ice of Management and Enterprise
438	438	Services for approval and payment.
439	439	5. The fund and the programs speci fied in this section funded
440	440	by revenues collected from the Nursing Facilities Quality of Care
441	441	Fee pursuant to this section are exempt from budgetary cuts ,
442	442	reductions, or eliminations.
443	443	6. The Medicaid rate increases for intermediate care facilities
444	444	for individuals with intelle ctual disabilities Intermediate Care
445	445	Facilities for Individuals with Intellectual Disabilities (ICFs/IID)
446	446	shall not exceed the net M edicaid rate increase for nursing
447	447	facilities including, but not limited to, the Medicaid rate increase
448	448	for which Medicaid-certified nursing facil ities are eligible due to
449	449	the Nursing Facilities Qualit y of Care Fee less the portion of that
450	450	increase attributable to treating the Nursing Facilities Quality of
451	451	Care Fee as an allowable cost.
452	452	7. The reimbursement rate for nursing facilities shall be made
453	453	in accordance with Oklahoma 's Medicaid reimbursement r ate
454	454	methodology and the provisions of this section.
455	455	8. No nursing facility shall be guaranteed, expres sly or
456	456	otherwise, that any additional costs reimbursed to the facility will
457	457	equal or exceed the am ount of the Nursing Facilities Qua lity of Care
458	458	Fee paid by the nursing facility.
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510	510	I. 1. In the event that fede ral financial participation
511	511	pursuant to Title XIX of the Social Security Act is not available to
512	512	the Oklahoma Medicaid program, for purposes of m atching expenditures
513	513	from the Nursing Facility Quality of Care Fund at the approved
514	514	federal medical assistance percentage for the applicable fiscal
515	515	year, the Nursing Facilities Quality of Care Fee shall be null and
516	516	void as of the date of the nonavailabilit y of such federal funding,
517	517	through and during any perio d of nonavailability.
518	518	2. In the event of an invalidatio n of this section by any court
519	519	of last resort under circumstances not covered in subsection J of
520	520	this section, the Nursing Facilities Quality of Care Fee shall be
521	521	null and void as of the effective dat e of that invalidation.
522	522	3. In the event that the Nursin g Facilities Quality of Care Fee
523	523	is determined to be null and void for any of the reasons enumerated
524	524	in this subsection, any Nursing Facilities Q uality of Care Fee
525	525	assessed and collected for any perio ds after such invalidation shall
526	526	be returned in full wit hin sixty (60) days by the Authority to the
527	527	nursing facility from which it was collected.
528	528	J. 1. If any provision of this section or the applica tion
529	529	thereof shall be adjudged to be invalid by any cou rt of last resort,
530	530	such judgment shall not affect, impai r or invalidate the provisions
531	531	of the section, but shall be confined in its operation to the
532	532	provision thereof directly involved in the controver sy in which such
533	533
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584	584	judgment was rendered. The applicabil ity of such provision to other
585	585	persons or circumstances shall not be affected thereby.
586	586	2. This subsection shall not apply to any judgment that affects
587	587	the rate of the Nursing Facilities Quality of Car e Fee, its
588	588	applicability to all li censed nursing homes in the state, the usage
589	589	of the fee for the purposes pres cribed in this section, or the
590	590	ability of the Authority to obtain full federal participation to
591	591	match its expenditures of the proceeds of the fee .
592	592	K. The Authority shall promulga te rules for the impl ementation
593	593	and enforcement of the Nursing Facilities Qua lity of Care Fee
594	594	established by this section.
595	595	L. The Authority shall provide for administrative penalties in
596	596	the event nursing facilities fail t o:
597	597	1. Submit the Quality of Care Fee;
598	598	2. Submit the fee in a timely manner;
599	599	3. Submit reports as required by this section; or
600	600	4. Submit reports timely.
601	601	M. As used in this section:
602	602	1. "Nursing facility" means any home, establishment or
603	603	institution, or any portion thereof, licensed by the State
604	604	Department of Health as defined in Section 1 -1902 of Title 63 of th e
605	605	Oklahoma Statutes;
606	606
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657	657	2. "Medicaid" means the medical assistance program established
658	658	in Title XIX of the federal Social Security Act and administ ered in
659	659	this state by the Authorit y;
660	660	3. "Patient gross revenues" means gross revenues received in
661	661	compensation for services provided to residents of nursing
662	662	facilities including, but not limited to, client participation. The
663	663	term "patient gross revenues " shall not include amounts receive d by
664	664	nursing facilities as charitable contributions; and
665	665	4. "Additional costs paid to Medicaid-certified nursing
666	666	facilities under Oklahoma's Medicaid reimbursement methodology "
667	667	means both state and federal Medicaid expend itures including, but
668	668	not limited to, funds in excess o f the aggregate amounts that would
669	669	otherwise have been p aid to Medicaid-certified nursing facilities
670	670	under the Medicaid reimbursement methodology which have been updated
671	671	for inflationary, economic, and regulatory trends and which are i n
672	672	effect immediately prior to the inception of the Nursing Facilities
673	673	Quality of Care Fee.
674	674	N. 1. As per any approved feder al Medicaid waiver, the
675	675	assessment rate subject to the provision of subsection C of this
676	676	section is to remain the same as those rate s that were in effect
677	677	prior to January 1, 2012, for all state -licensed continuum of care
678	678	facilities.
679	679	2. Any facilities that made application to the State Department
680	680	of Health to become a licensed continuum of care facilit y no later
681	681
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732	732	than January 1, 2012, s hall be assessed at t he same rate as those
733	733	facilities assessed pursuant to pa ragraph 1 of this subsection;
734	734	provided, that any facility making the application shall receive the
735	735	license on or before September 1, 2012. Any f acility that fails to
736	736	receive such license from the Sta te Department of Health by
737	737	September 1, 2012, shall be a ssessed at the rate established by
738	738	subsection C of this section subsequent to September 1, 2012.
739	739	O. If any provision of this section, or the app lication
740	740	thereof, is determined by any controlling fede ral agency, or any
741	741	court of last resort , to prevent the state from obtaining federal
742	742	financial participation in the state's Medicaid program, such
743	743	provision shall be deemed null and void as of the date of the
744	744	nonavailability of such fed eral funding and thro ugh and during any
745	745	period of nonavailability. All othe r provisions of the bill this
746	746	section shall remain valid and enforceable.
747	747	SECTION 2. This act shall become effective November 1, 2024.
748	748
749	749	59-2-8495 TJ 11/30/23

Oklahoma 2024 Regular Session

Oklahoma House Bill HB3025 Compare Versions