Assembly Bill No. 297–Assemblymen Sherer, Knecht, Gibbons, Andonov, Angle, Brown, Christensen, Conklin, Geddes, Goicoechea, Grady, Griffin, Gustavson, Hardy, Hettrick, Koivisto, Mabey, Marvel, McClain, Mortenson and Weber

 

March 13, 2003

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Joint Sponsor: Senator McGinness

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Referred to Committee on Health and Human Services

 

SUMMARY—Revises provisions governing payment of hospitals for treating disproportionate share of Medicaid patients, indigent patients or other low-income patients. (BDR 38‑885)

 

FISCAL NOTE:    Effect on Local Government: No.

                             Effect on the State: No.

 

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EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

 

AN ACT relating to public welfare; requiring the payments made for a hospital treating a disproportionate share of Medicaid patients, indigent patients or other low-income patients to be made to the county in which the hospital is located; requiring the hospital to submit a claim against the county for the money received by the county; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

1-1  Section 1. NRS 422.382 is hereby amended to read as follows:

1-2  422.382  1.  In a county within which:

1-3  (a) A public hospital is located, the state or local government or

1-4  other entity responsible for the public hospital shall transfer an

1-5  amount equal to 75 percent of the total amount distributed to that

2-1  hospital pursuant to NRS 422.387 for a fiscal year, less $75,000, to

2-2  the Division of Health Care Financing and Policy.

2-3  (b) A private hospitalwhich receives a payment from money

2-4  that was provided to a county pursuant to:

2-5       (1) Paragraph (b) of subsection 2 of NRS 422.387 , is

2-6  located, the county shall transfer:

2-7           (I) Except as otherwise provided in sub-subparagraph (II),

2-8  an amount equal to 75 percent of the total amount distributed to that

2-9  hospital from money that was provided to a county pursuant to

2-10  paragraph (b) of subsection 2 of NRS 422.387 for a fiscal year; or

2-11              (II) An amount established by the Legislature for a fiscal

2-12  year,

2-13  to the Division of Health Care Financing and Policy.

2-14          (2) Paragraph (c) of subsection 2 of NRS 422.387 , is

2-15  located, the county shall transfer:

2-16              (I) An amount equal to 75 percent of the total amount

2-17  distributed to that hospital from money that was provided to a

2-18  county pursuant to that paragraph for a fiscal year, less $75,000; or

2-19              (II) Any maximum amount established by the Legislature

2-20  for a fiscal year,

2-21  whichever is less, to the Division of Health Care Financing and

2-22  Policy.

2-23      2.  A county that transfers the amount required pursuant to

2-24  subparagraph (1) of paragraph (b) of subsection 1 to the Division of

2-25  Health Care Financing and Policy is discharged of the duty and is

2-26  released from liability for providing medical treatment for indigent

2-27  inpatients who are treated in the hospital in the county that receives

2-28  a payment pursuant to paragraph (b) of subsection 2 of

2-29  NRS 422.387.

2-30      3.  The money transferred to the Division of Health Care

2-31  Financing and Policy pursuant to subsection 1 must not come from

2-32  any source of funding that could result in any reduction in revenue

2-33  to the State pursuant to 42 U.S.C. § 1396b(w).

2-34      4.  Any money collected pursuant to subsection 1, including

2-35  any interest or penalties imposed for a delinquent payment, must be

2-36  deposited in the State Treasury for credit to the Intergovernmental

2-37  Transfer Account in the State General Fund to be administered by

2-38  the Division of Health Care Financing and Policy.

2-39      5.  The interest and income earned on money in the

2-40  Intergovernmental Transfer Account, after deducting any applicable

2-41  charges, must be credited to the Account.

2-42      Sec. 2.  NRS 422.387 is hereby amended to read as follows:

2-43      422.387  1.  Before making the payments required or

2-44  authorized by this section, the Division of Health Care Financing

2-45  and Policy shall allocate money for the administrative costs

3-1  necessary to carry out the provisions of NRS 422.380 to 422.390,

3-2  inclusive. The amount allocated for administrative costs must not

3-3  exceed the amount authorized for expenditure by the Legislature for

3-4  this purpose in a fiscal year. The Interim Finance Committee may

3-5  adjust the amount allowed for administrative costs.

3-6  2.  The State Plan for Medicaid must provide:

3-7  (a) For the payment of the maximum amount allowable under

3-8  federal law and regulations after making any payments pursuant to

3-9  paragraphs (b) and (c), to the counties in which public hospitals are

3-10  located to pay such hospitals for treating a disproportionate share of

3-11  Medicaid patients, indigent patients or other low-income patients,

3-12  unless such payments are subsequently limited by federal law or

3-13  regulation.

3-14      (b) For a payment in an amount approved by the Legislature to

3-15  each county that does not have a public hospital and in which the

3-16  private hospital that provides the largest volume of medical care to

3-17  Medicaid patients, indigent patients or other low-income patients in

3-18  [a county that does not have a public hospital.] that county has been

3-19  allocated a payment.

3-20      (c) For a payment to each county that has a public hospital and

3-21  in which a private hospital is located whose Medicaid utilization

3-22  percentage is greater than the average for all the hospitals in this

3-23  state [and which is located in a county that has a public hospital,] ,

3-24  in an amount equal to:

3-25          (1) If the Medicaid utilization percentage of the private

3-26  hospital is greater than 20 percent, $200 for each uncompensated

3-27  day incurred by the hospital; and

3-28          (2) If the Medicaid utilization percentage of the private

3-29  hospital is 20 percent or less, $100 for each uncompensated day

3-30  incurred by the hospital.

3-31  The Plan must be consistent with the provisions of NRS 422.380 to

3-32  422.390, inclusive, and Title XIX of the Social Security Act, 42

3-33  U.S.C. §§ 1396 et seq., and the regulations adopted pursuant to

3-34  those provisions.

3-35      3.  To the extent that money is available in the

3-36  Intergovernmental Transfer Account, the Division of Health Care

3-37  Financing and Policy shall distribute $50,000 from that Account

3-38  each fiscal year to each [public hospital] county in which:

3-39      (a) [Is located in a county that does not have any other hospitals;

3-40  and

3-41      (b) Is] A public hospital which is not eligible for a payment

3-42  from money provided to a county pursuant to subsection 2[.] is

3-43  located; and

3-44      (b) There are no other hospitals.

4-1  4.  Any hospital which is qualified to receive a payment from

4-2  money provided to a county pursuant to subsection 2 or 3 must

4-3  submit a claim against the county in which the hospital is located

4-4  for money paid to the county pursuant to subsection 2 or 3. All

4-5  claims for payment pursuant to this section must be allowed and

4-6  the board of county commissioners of the county in which the

4-7  hospital is located shall pay such claims in the same manner as

4-8  other claims against the county are paid as provided for by law.

4-9  5.  As used in this section:

4-10      (a) “Medicaid utilization percentage” means the total number of

4-11  days of treatment of Medicaid patients, including patients who

4-12  receive their Medicaid benefits through a health maintenance

4-13  organization, divided by the total number of days of treatment of all

4-14  patients during a fiscal year.

4-15      (b) “Uncompensated day” means a day in which medical care is

4-16  provided to an inpatient for which a hospital receives:

4-17          (1) Not more than 25 percent of the cost of providing that

4-18  care from the patient; and

4-19          (2) No compensation for the cost of providing that care from

4-20  any other person or any governmental program.

4-21      Sec. 3.  This act becomes effective on July 1, 2003.

 

4-22  H