Wisconsin 2023-2024 Regular Session

Wisconsin Senate Bill SB1028

Introduced
2/13/24  
Refer
2/13/24  

Caption

Supplemental payments to hospitals with avoidable patient days and an enhanced rate to nursing homes for bariatric and extensive wound care under the Medical Assistance program. (FE)

Impact

The implementation of SB1028 is expected to result in significant financial relief for hospitals caring for high-acuity patients who cannot be discharged due to a lack of available care settings. Beginning in July 2024, the Department of Health Services (DHS) will allocate a total of $5 million each quarter, supplemented by federal matching funds. Hospitals will receive a payment proportional to their qualifying avoidable patient days. Furthermore, the bill mandates the establishment of an enhanced reimbursement rate for nursing homes caring for bariatric patients or those requiring extensive wound care, specifically for residents admitted after July 1, 2024.

Summary

Senate Bill 1028 addresses the provision of supplemental payments to hospitals for patients who experience avoidable patient days, as well as enhanced reimbursement rates for nursing homes providing bariatric and extensive wound care under the Medical Assistance program. The bill outlines specific criteria for identifying qualifying avoidable patient days, which occur once a high-acuity patient has been eligible for discharge from a hospital for a consecutive seven-day period without finding a safe discharge setting. This initiative aims to mitigate the financial impacts on hospitals that care for such patients who are unable to be discharged timely due to care setting availability issues.

Contention

While the bill seeks to provide essential support to healthcare providers, there may be contention regarding the details of its implementation and potential impact on overall healthcare costs. Lawmakers and stakeholders may express concerns over the adequacy of funding and the clarity of eligibility criteria for both hospitals and nursing homes. Furthermore, whether the enhancements to reimbursement rates will sufficiently cover the actual costs incurred by healthcare providers for specialized care remains a point of discussions among advocates and critics of the bill.

Companion Bills

No companion bills found.

Previously Filed As

WI AB1087

Supplemental payments to hospitals with avoidable patient days and an enhanced rate to nursing homes for bariatric and extensive wound care under the Medical Assistance program. (FE)

WI AB1086

Funding for supplemental payments to hospitals with avoidable patient days under the Medical Assistance program, for enhanced nursing home reimbursement rates under the Medical Assistance program for residents with bariatric and extensive wound care needs, and for the complex patient pilot program. (FE)

WI SB1029

Funding for supplemental payments to hospitals with avoidable patient days under the Medical Assistance program, for enhanced nursing home reimbursement rates under the Medical Assistance program for residents with bariatric and extensive wound care needs, and for the complex patient pilot program. (FE)

WI HF3342

Nursing facility workforce incentive program, nursing facility payments, and nursing facility temporary rate add-on provided; partial reimbursement to hospitals provided for qualifying avoidable patient days; and money appropriated.

WI S2714

Requires all hospitals to screen uninsured patients for eligibility for public health programs and financial assistance under Medicare and Medicaid.

WI AB1088

Consent to admissions to certain health care facilities by patient representatives, allocation of nursing beds for patients with certain complex needs, and a complex patient pilot program. (FE)

WI SB1027

Consent to admissions to certain health care facilities by patient representatives, allocation of nursing beds for patients with certain complex needs, and a complex patient pilot program. (FE)

WI SF3989

Medical assistance eligibility timeline modifications for certain hospital patients and providing supplemental payments for certain disability waiver services

WI HF2848

Temporary funding established for settings that receive high-acuity patients discharged from hospitals, grants established to reimburse hospitals for avoidable nonacute patient days, and money appropriated.

WI HF2057

Assessment on hospitals imposed, directed payments to hospitals in the medical assistance program required, and reports required.

Similar Bills

CA AB2118

Medi-Cal: emergency medical transportation services.

CA AB1705

Medi-Cal: emergency medical transportation services.

NJ S1244

Supplemental appropriation of $25 million to DOH to assist certain mental health and addiction service providers transitioning to fee-for-service reimbursement system.

NJ S1003

Supplemental appropriation of $25 million to DOH to assist certain mental health and addiction service providers transitioning to fee-for-service reimbursement system.

LA SB489

Requires the Department of Education to reimburse local school boards for salary supplements paid to certain nationally board certified school personnel. (gov sig) (OR +$16,250,000 GF EX See Note)

LA SB286

Requires the Dept. of Education to reimburse local school boards for salary supplements paid to certain nationally board certified school personnel. (gov sig) (EG +$16,250,000 GF EX See Note)

NM SB463

Emergency Medical Medicaid Reimbursement

MI HB5695

Human services: medical services; participation in the ground emergency medical transport reimbursement program; require. Amends 1939 PA 280 (MCL 400.1 - 400.119b) by adding sec. 109p.