EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

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

1-2 study of the methodology used in determining the amount and distribution

1-3 of payments made to public and private hospitals pursuant to NRS 422.387.

1-4 The study must review:

1-5 (a) Whether the payments received by hospitals based on the volume of

1-6 medical care provided to Medicaid patients, indigent patients and other

1-7 low-income patients are equitable;

1-8 (b) Whether it is feasible to redistribute payments to increase payments

1-9 to hospitals located in rural counties;

1-10 (c) Whether it is feasible to redistribute payments to provide payments

1-11 to private hospitals located in counties that have a public hospital; and

1-12 (d) Alternative sources of revenue that may be used to offset the cost of

1-13 care provided to Medicaid patients, indigent patients and other low-income

1-14 patients.

2-1 2. The Department shall seek to obtain relevant information from

2-2 public and private hospitals as part of the study. Any such information

2-3 obtained by the Department may be used only for the purpose of

2-4 conducting the study.

2-5 3. The Department shall complete the study and submit a copy of its

2-6 findings and recommendations on or before July 1, 2000, to the Governor,

2-7 the Interim Finance Committee and the Legislative Committee on Health

2-8 Care.

2-9 Sec. 2. 1. The state controller shall, as soon as practicable after
2-10 July 1, 1999, transfer from the intergovernmental transfer account in the

2-11 general fund to the fund for the institutional care of the medically indigent

2-12 created pursuant to NRS 428.470 the amount necessary to restore the

2-13 amount in the fund for the institutional care of the medically indigent to

2-14 $300,000.

2-15 2. The money transferred to the fund for the institutional care of the

2-16 medically indigent pursuant to subsection 1 may be used to provide

2-17 assistance to a county for a payment required by an interlocal agreement

2-18 which became due during fiscal year 1998-1999 or becomes due during

2-19 fiscal year 1999-2000 or 2000-2001.

2-20 3. As used in this section, "interlocal agreement" has the meaning

2-21 ascribed to it in NRS 428.440.

2-22 Sec. 3. 1. Except as otherwise provided in subsection 2:

2-23 (a) In a county whose population is more than 100,000 but less than

2-24 400,000, the state plan for Medicaid must allocate among any private

2-25 hospitals that are qualified to receive a payment pursuant to NRS 422.387

2-26 and that are located in a county which does not have a public hospital or

2-27 hospital district, $4,800,000 or the amount of the uncompensated costs of

2-28 the hospitals as defined in the state plan for Medicaid, whichever is less, for

2-29 the fiscal year 1999-2000 and for the fiscal year 2000-2001.

2-30 (b) The state plan for Medicaid may allocate among any private

2-31 hospitals that are qualified to receive a payment pursuant to NRS 422.387

2-32 and that are located in a county which does not have a public hospital or

2-33 hospital district:

2-34 (1) In a county whose population is more than 35,000 but less than

2-35 100,000, $2,000,000 or the amount of the uncompensated costs of the

2-36 hospitals as defined in the state plan for Medicaid, whichever is less, for the

2-37 fiscal year 1999-2000 and for the fiscal year 2000-2001.

2-38 (2) In a county whose population is less than 35,000, $1,000,000 or

2-39 the amount of the uncompensated costs of the hospitals as defined in the

2-40 state plan for Medicaid, whichever is less, for the fiscal year 1999-2000

2-41 and for the fiscal year 2000-2001.

3-1 (c) If a private hospital receives a payment pursuant to paragraph (a) or

3-2 (b), the county within which the hospital is located shall transfer to the

3-3 Department of Human Resources:

3-4 (1) If the payment was received pursuant to paragraph (a), $1,550,000

3-5 for the fiscal year 1999-2000 and for the fiscal year 2000-2001.

3-6 (2) If the payment was received pursuant to subparagraph (1) of

3-7 paragraph (b), $1,500,000 or 75 percent of the amount received by the

3-8 hospital, whichever is less, for the fiscal year 1999-2000 and for the fiscal

3-9 year 2000-2001.

3-10 (3) If the payment was received pursuant to subparagraph (2) of

3-11 paragraph (b), $750,000 or 75 percent of the amount received by the

3-12 hospital, whichever is less, for the fiscal year 1999-2000 and for the fiscal

3-13 year 2000-2001.

3-14 2. If federal law changes the amount payable pursuant to paragraph (a)

3-15 of subsection 2 of NRS 422.387:

3-16 (a) The respective amounts required to be allocated and transferred

3-17 pursuant to subsection 1 must be reduced proportionally in accordance with

3-18 the limits of federal law.

3-19 (b) The Administrator of the Division of Health Care Financing and

3-20 Policy of the Department of Human Resources shall adopt a regulation

3-21 specifying the amount of the reductions required by paragraph (a).

3-22 Sec. 4. This act becomes effective on July 1, 1999.