1. 
   and Human Services

CHAPTER........

Section 1. 1. The Department of Human Resources shall conduct a

study of the methodology used in determining the amount and distribution

of payments made to public and private hospitals pursuant to NRS 422.387.

The study must review:

(a) Whether the payments received by hospitals based on the volume of

medical care provided to Medicaid patients, indigent patients and other

low-income patients are equitable;

(b) Whether it is feasible to redistribute payments to increase payments

to hospitals located in rural counties;

(c) Whether it is feasible to redistribute payments to provide payments

to private hospitals located in counties that have a public hospital; and

(d) Alternative sources of revenue that may be used to offset the cost of

care provided to Medicaid patients, indigent patients and other low-income

patients.

2. The Department shall seek to obtain relevant information from

public and private hospitals as part of the study. Any such information

obtained by the Department may be used only for the purpose of

conducting the study.

1. 3. The Department shall complete the study and submit a copy of its

1. findings and recommendations on or before July 1, 2000, to the Governor,

1. the Interim Finance Committee and the Legislative Committee on Health

1. Care.

Sec. 2. 1. The state controller shall, as soon as practicable after
July 1, 1999, transfer from the intergovernmental transfer account in the

general fund to the fund for the institutional care of the medically indigent

created pursuant to NRS 428.470 the amount necessary to restore the

amount in the fund for the institutional care of the medically indigent to

$300,000.

2. The money transferred to the fund for the institutional care of the

medically indigent pursuant to subsection 1 may be used to provide

assistance to a county for a payment required by an interlocal agreement

which became due during fiscal year 1998-1999 or becomes due during

fiscal year 1999-2000 or 2000-2001.

3. As used in this section, "interlocal agreement" has the meaning

ascribed to it in NRS 428.440.

Sec. 3. 1. Except as otherwise provided in subsection 2:

(a) In a county whose population is more than 100,000 but less than

400,000, the state plan for Medicaid must allocate among any private

hospitals that are qualified to receive a payment pursuant to NRS 422.387

and that are located in a county which does not have a public hospital or

hospital district, $4,800,000 or the amount of the uncompensated costs of

the hospitals as defined in the state plan for Medicaid, whichever is less, for

the fiscal year 1999-2000 and for the fiscal year 2000-2001.

(b) The state plan for Medicaid may allocate among any private

hospitals that are qualified to receive a payment pursuant to NRS 422.387

and that are located in a county which does not have a public hospital or

hospital district:

(1) In a county whose population is more than 35,000 but less than

100,000, $2,000,000 or the amount of the uncompensated costs of the

hospitals as defined in the state plan for Medicaid, whichever is less, for the

fiscal year 1999-2000 and for the fiscal year 2000-2001.

(2) In a county whose population is less than 35,000, $1,000,000 or

the amount of the uncompensated costs of the hospitals as defined in the

state plan for Medicaid, whichever is less, for the fiscal year 1999-2000

and for the fiscal year 2000-2001.

(c) If a private hospital receives a payment pursuant to paragraph (a) or

(b), the county within which the hospital is located shall transfer to the

Department of Human Resources:

(1) If the payment was received pursuant to paragraph (a), $1,550,000

for the fiscal year 1999-2000 and for the fiscal year 2000-2001.

(2) If the payment was received pursuant to subparagraph (1) of

paragraph (b), $1,500,000 or 75 percent of the amount received by the

hospital, whichever is less, for the fiscal year 1999-2000 and for the fiscal

year 2000-2001.

(3) If the payment was received pursuant to subparagraph (2) of

paragraph (b), $750,000 or 75 percent of the amount received by the

hospital, whichever is less, for the fiscal year 1999-2000 and for the fiscal

year 2000-2001.

2. If federal law changes the amount payable pursuant to paragraph (a)

of subsection 2 of NRS 422.387:

(a) The respective amounts required to be allocated and transferred

pursuant to subsection 1 must be reduced proportionally in accordance with

the limits of federal law.

(b) The Administrator of the Division of Health Care Financing and

Policy of the Department of Human Resources shall adopt a regulation

specifying the amount of the reductions required by paragraph (a).

Sec. 4. This act becomes effective on July 1, 1999.

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