81R11568 KLA-D
By: Rose H.B. No. 4158
A BILL TO BE ENTITLED
AN ACT
relating to reimbursement rates for nursing home services provided
to Medicaid recipients.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 531.021(e), Government Code, is amended
to read as follows:
(e) Notwithstanding any other provision of Chapter 32,
Human Resources Code, Chapter 533, or this chapter, the commission
may:
(1) adjust the fees, charges, and rates paid to
Medicaid providers as necessary to achieve the objectives of the
Medicaid program in a manner consistent with the considerations
described by Subsection (d); and
(2) adjust the fees, charges, and rates paid for
nursing home services based on the commission's findings related to
factors analyzed under Section 32.028(q), Human Resources Code.
SECTION 2. Section 32.028, Human Resources Code, is amended
by amending Subsection (n) and adding Subsection (q) to read as
follows:
(n) The executive commissioner of the Health and Human
Services Commission [commission] shall ensure that rules governing
the determination of rates paid for nursing home services provide
for the reporting of all revenue received and costs incurred,
without regard to whether a cost is an allowable cost for
reimbursement under the medical assistance program, except:
(1) as provided by Subsection (h); and
(2) a penalty imposed under this chapter or Chapter
242, Health and Safety Code.
(q) The Health and Human Services Commission shall
periodically conduct an analysis of the base rates paid for nursing
home services provided under the medical assistance program to
enable the executive commissioner of the commission to
appropriately set future rates. In conducting the analysis, the
commission may consider any factors the commission considers
relevant, including:
(1) the costs incurred by nursing homes to provide
services to recipients of medical assistance;
(2) the inflation rate;
(3) rates paid in other states for comparable
services; and
(4) incentives offered under Subsection (g) to improve
quality of care.
SECTION 3. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 4. This Act takes effect September 1, 2009.