requires two-thirds majority vote (§ 7)
A.B. 395
Assembly Bill No. 395–Assemblyman Goldwater
March 17, 2003
____________
Referred to Committee on Health and Human Services
SUMMARY—Provides for assessment of fee on facilities for intermediate care and facilities for skilled nursing. (BDR 38‑999)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State: Yes.
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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).
AN ACT relating to public welfare; providing for an assessment of a fee on facilities for intermediate care and facilities for skilled nursing; requiring the Division of Health Care Financing and Policy of the Department of Human Resources to administer the provisions concerning the assessment; 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. Chapter 422 of NRS is hereby amended by adding
1-2 thereto the provisions set forth as sections 2 to 9, inclusive, of this
1-3 act.
1-4 Sec. 2. As used in sections 2 to 9, inclusive, of this act, unless
1-5 the context otherwise requires, the words and terms defined in
1-6 sections 3, 4 and 5 of this act have the meanings ascribed to them
1-7 in those sections.
1-8 Sec. 3. “Facility for intermediate care” has the meaning
1-9 ascribed to it in NRS 449.0038, but does not include a facility
1-10 which meets the requirements of a general or any other special
1-11 hospital pursuant to chapter 449 of NRS.
1-12 Sec. 4. “Facility for skilled nursing” has the meaning
1-13 ascribed to it in NRS 449.0039.
2-1 Sec. 5. “Nursing facility” means a facility for intermediate
2-2 care or a facility for skilled nursing.
2-3 Sec. 6. 1. Each nursing facility that is licensed in this state
2-4 shall pay a fee assessed by the Division of Health Care Financing
2-5 and Policy to increase the quality of nursing care in this state.
2-6 2. To determine the amount of the fee to assess pursuant to
2-7 this section, the Division of Health Care Financing and Policy
2-8 shall establish a uniform rate per non-Medicare patient day that is
2-9 equivalent to 6 percent of the total annual accrual basis gross
2-10 revenue for services provided to patients of all nursing facilities
2-11 licensed in this state. For the purposes of this subsection, total
2-12 annual accrual basis gross revenue does not include charitable
2-13 contributions received by a nursing facility.
2-14 3. The Division of Health Care Financing and Policy shall
2-15 calculate the fee owed by each nursing facility by multiplying the
2-16 total number of days of care provided to non-Medicare patients by
2-17 the nursing facility, as provided to the Division pursuant to section
2-18 7 of this act, by the uniform rate established pursuant to
2-19 subsection 2.
2-20 4. A fee assessed pursuant to this section is due 30 days after
2-21 the end of the month for which the fee was assessed.
2-22 5. The payment of a fee to the Division of Health Care
2-23 Financing and Policy pursuant to sections 2 to 9, inclusive, of this
2-24 act is an allowable cost for Medicaid reimbursement purposes.
2-25 Sec. 7. 1. Each nursing facility shall file with the Division
2-26 of Health Care Financing and Policy each month a report setting
2-27 forth the total number of days of care it provided to non-Medicare
2-28 patients during the preceding month, the total gross revenue it
2-29 earned as compensation for services provided to patients during
2-30 the preceding month and any other information required by the
2-31 Division.
2-32 2. Each nursing facility shall file with the Division of Health
2-33 Care Financing and Policy any information required and
2-34 requested by the Division to carry out the provisions of sections 2
2-35 to 9, inclusive, of this act.
2-36 Sec. 8. 1. There is hereby created in the State Treasury the
2-37 Fund to Increase the Quality of Nursing Care, to be administered
2-38 by the Division of Health Care Financing and Policy.
2-39 2. The Fund to Increase the Quality of Nursing Care must be
2-40 a separate and continuing fund, and no money in the Fund reverts
2-41 to the State General Fund at any time. The interest and income on
2-42 the money in the Fund, after deducting any applicable charges,
2-43 must be credited to the Fund.
2-44 3. Any money received by the Division of Health Care
2-45 Financing and Policy pursuant to sections 2 to 9, inclusive, of this
3-1 act must be deposited in the State Treasury for credit to the Fund
3-2 to Increase the Quality of Nursing Care.
3-3 4. Any money received by the State of Nevada from the
3-4 Federal Government as a result of federal financial participation
3-5 in the Medicaid program that is derived from the fees paid
3-6 pursuant to sections 2 to 9, inclusive, of this act must be deposited
3-7 in the State Treasury for credit to the Fund to Increase the Quality
3-8 of Nursing Care.
3-9 5. Expenditures from the Fund to Increase the Quality of
3-10 Nursing Care must be used only to increase the rates paid to
3-11 nursing facilities for providing services pursuant to the Medicaid
3-12 program and may not be used to replace existing state
3-13 expenditures paid to nursing facilities for providing services
3-14 pursuant to the Medicaid program.
3-15 Sec. 9. The Division of Health Care Financing and Policy
3-16 shall establish administrative penalties for the late payment by a
3-17 nursing facility of a fee assessed pursuant to sections 2 to 9,
3-18 inclusive, of this act.
3-19 Sec. 10. NRS 422.2352 is hereby amended to read as follows:
3-20 422.2352 As used in sections 2 to 9, inclusive, of this act, NRS
3-21 422.2352 to 422.2374, inclusive, 422.301 to 422.306, inclusive, and
3-22 422.380 to 422.390, inclusive, unless the context otherwise requires,
3-23 “Administrator” means the Administrator of the Division of Health
3-24 Care Financing and Policy.
3-25 Sec. 11. NRS 422.2368 is hereby amended to read as follows:
3-26 422.2368 The Administrator may adopt such regulations as are
3-27 necessary for the administration of NRS 422.2352 to 422.2374,
3-28 inclusive, 422.301 to 422.306, inclusive, 422.380 to 422.390,
3-29 inclusive, and 422.580[.] , and sections 2 to 9, inclusive, of this
3-30 act.
3-31 Sec. 12. NRS 422.2372 is hereby amended to read as follows:
3-32 422.2372 The Administrator shall:
3-33 1. Supply the Director with material on which to base proposed
3-34 legislation.
3-35 2. Cooperate with the Federal Government and state
3-36 governments for the more effective attainment of the purposes of
3-37 this chapter.
3-38 3. Coordinate the activities of the Division of Health Care
3-39 Financing and Policy with other agencies, both public and private,
3-40 with related or similar activities.
3-41 4. Keep a complete and accurate record of all proceedings,
3-42 record and file all bonds and contracts, and assume responsibility for
3-43 the custody and preservation of all papers and documents pertaining
3-44 to his office.
4-1 5. Inform the public in regard to the activities and operation of
4-2 the Division, and provide other information which will acquaint the
4-3 public with the financing of Medicaid programs.
4-4 6. Conduct studies into the causes of the social problems with
4-5 which the Division is concerned.
4-6 7. Invoke any legal, equitable or special procedures for the
4-7 enforcement of his orders or the enforcement of NRS 422.2352 to
4-8 422.2374, inclusive, 422.301 to 422.306, inclusive, 422.380 to
4-9 422.390, inclusive, and 422.580[.] , and sections 2 to 9, inclusive,
4-10 of this act.
4-11 8. Exercise any other powers that are necessary and proper for
4-12 the standardization of state work, to expedite business, and to
4-13 promote the efficiency of the service provided by the Division.
4-14 Sec. 13. NRS 422.301 is hereby amended to read as follows:
4-15 422.301 The Administrator and the Division of Health Care
4-16 Financing and Policy shall administer the provisions of NRS
4-17 422.2352 to 422.2374, inclusive, 422.301 to 422.306, inclusive,
4-18 422.380 to 422.390, inclusive, and 422.580, and sections 2 to 9,
4-19 inclusive, of this act, subject to administrative supervision by the
4-20 Director.
4-21 Sec. 14. 1. The Division of Health Care Financing and
4-22 Policy of the Department of Human Resources shall begin assessing
4-23 fees pursuant to this act on July 1, 2003.
4-24 2. A nursing facility does not owe a fee assessed pursuant to
4-25 this act until:
4-26 (a) The amendment to the State Plan for Medicaid which
4-27 increases the rates paid to nursing facilities for providing services
4-28 pursuant to the Medicaid program is approved by the Federal
4-29 Government; and
4-30 (b) The nursing facilities have been compensated retroactively at
4-31 the increased rate for services provided pursuant to the Medicaid
4-32 program on or after July 1, 2003.
4-33 Sec. 15. 1. This section and section 7 of this act become
4-34 effective upon passage and approval.
4-35 2. Sections 1 to 6, inclusive, and 8 to 14, inclusive, of this act
4-36 become effective:
4-37 (a) Upon passage and approval for the purpose of adopting
4-38 regulations; and
4-39 (b) On July 1, 2003, for all other purposes.
4-40 H