REQUIRES TWO-THIRDS MAJORITY VOTE (§ 6)          exempt

                                                 (Reprinted with amendments adopted on April 16, 2003)

 

Assembly Bill No. 395–Assemblyman Goldwater

 

March 17, 2003

____________

 

Referred to Committee on Health and Human Services

 

SUMMARY—Provides for assessment of fee on certain facilities for intermediate care and on 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.

 

AN ACT relating to public welfare; providing for an assessment of a fee on certain facilities for intermediate care and on 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:

1-10      1.  A facility which meets the requirements of a general or any

1-11  other special hospital pursuant to chapter 449 of NRS; or

1-12      2.  A facility for intermediate care which limits its care and

1-13  treatment to those persons who are mentally retarded or who have

1-14  conditions related to mental retardation.

2-1  Sec. 4.  “Facility for skilled nursing” has the meaning

2-2  ascribed to it in NRS 449.0039.

2-3  Sec. 5.  “Nursing facility” means a facility for intermediate

2-4  care or a facility for skilled nursing.

2-5  Sec. 6.  1.  Each nursing facility that is licensed in this state

2-6  shall pay a fee assessed by the Division of Health Care Financing

2-7  and Policy to increase the quality of nursing care in this state.

2-8  2.  To determine the amount of the fee to assess pursuant to

2-9  this section, the Division of Health Care Financing and Policy

2-10  shall establish a uniform rate per non-Medicare patient day that is

2-11  equivalent to 6 percent of the total annual accrual basis gross

2-12  revenue for services provided to patients of all nursing facilities

2-13  licensed in this state. For the purposes of this subsection, total

2-14  annual accrual basis gross revenue does not include charitable

2-15  contributions received by a nursing facility.

2-16      3.  The Division of Health Care Financing and Policy shall

2-17  calculate the fee owed by each nursing facility by multiplying the

2-18  total number of days of care provided to non-Medicare patients by

2-19  the nursing facility, as provided to the Division pursuant to section

2-20  7 of this act, by the uniform rate established pursuant to

2-21  subsection 2.

2-22      4.  A fee assessed pursuant to this section is due 30 days after

2-23  the end of the month for which the fee was assessed.

2-24      5.  The payment of a fee to the Division of Health Care

2-25  Financing and Policy pursuant to sections 2 to 9, inclusive, of this

2-26  act is an allowable cost for Medicaid reimbursement purposes.

2-27      Sec. 7.  1.  Each nursing facility shall file with the Division

2-28  of Health Care Financing and Policy each month a report setting

2-29  forth the total number of days of care it provided to non-Medicare

2-30  patients during the preceding month, the total gross revenue it

2-31  earned as compensation for services provided to patients during

2-32  the preceding month and any other information required by the

2-33  Division.

2-34      2.  Each nursing facility shall file with the Division of Health

2-35  Care Financing and Policy any information required and

2-36  requested by the Division to carry out the provisions of sections 2

2-37  to 9, inclusive, of this act.

2-38      Sec. 8.  1.  There is hereby created in the State Treasury the

2-39  Fund to Increase the Quality of Nursing Care, to be administered

2-40  by the Division of Health Care Financing and Policy.

2-41      2.  The Fund to Increase the Quality of Nursing Care must be

2-42  a separate and continuing fund, and no money in the Fund reverts

2-43  to the State General Fund at any time. The interest and income on

2-44  the money in the Fund, after deducting any applicable charges,

2-45  must be credited to the Fund.

3-1  3.  Any money received by the Division of Health Care

3-2  Financing and Policy pursuant to sections 2 to 9, inclusive, of this

3-3  act must be deposited in the State Treasury for credit to the Fund

3-4  to Increase the Quality of Nursing Care, and must be expended, to

3-5  the extent authorized by federal law, to obtain federal financial

3-6  participation in the Medicaid Program, and in the manner set

3-7  forth in subsection 4.

3-8  4.  Expenditures from the Fund to Increase the Quality of

3-9  Nursing Care must be used only:

3-10      (a) To increase the rates paid to nursing facilities for providing

3-11  services pursuant to the Medicaid Program and may not be used to

3-12  replace existing state expenditures paid to nursing facilities for

3-13  providing services pursuant to the Medicaid Program; and

3-14      (b) To administer the provisions of sections 2 to 9, inclusive, of

3-15  this act. The amount expended pursuant to this paragraph must

3-16  not exceed 1 percent of the money received from the fees assessed

3-17  pursuant to sections 2 to 9, inclusive, of this act, and must not

3-18  exceed the amount authorized for expenditure by the Legislature

3-19  for administrative expenses in a fiscal year.

3-20      Sec. 9.  The Division of Health Care Financing and Policy

3-21  shall establish administrative penalties for the late payment by a

3-22  nursing facility of a fee assessed pursuant to sections 2 to 9,

3-23  inclusive, of this act.

3-24      Sec. 10.  NRS 422.2352 is hereby amended to read as follows:

3-25      422.2352  As used in sections 2 to 9, inclusive, of this act, NRS

3-26  422.2352 to 422.2374, inclusive, 422.301 to 422.306, inclusive, and

3-27  422.380 to 422.390, inclusive, unless the context otherwise requires,

3-28  “Administrator” means the Administrator of the Division of Health

3-29  Care Financing and Policy.

3-30      Sec. 11.  NRS 422.2368 is hereby amended to read as follows:

3-31      422.2368  The Administrator may adopt such regulations as are

3-32  necessary for the administration of NRS 422.2352 to 422.2374,

3-33  inclusive, 422.301 to 422.306, inclusive, 422.380 to 422.390,

3-34  inclusive, and 422.580[.] , and sections 2 to 9, inclusive, of this

3-35  act.

3-36      Sec. 12.  NRS 422.2372 is hereby amended to read as follows:

3-37      422.2372  The Administrator shall:

3-38      1.  Supply the Director with material on which to base proposed

3-39  legislation.

3-40      2.  Cooperate with the Federal Government and state

3-41  governments for the more effective attainment of the purposes of

3-42  this chapter.

3-43      3.  Coordinate the activities of the Division of Health Care

3-44  Financing and Policy with other agencies, both public and private,

3-45  with related or similar activities.

4-1  4.  Keep a complete and accurate record of all proceedings,

4-2  record and file all bonds and contracts, and assume responsibility for

4-3  the custody and preservation of all papers and documents pertaining

4-4  to his office.

4-5  5.  Inform the public in regard to the activities and operation of

4-6  the Division, and provide other information which will acquaint the

4-7  public with the financing of Medicaid programs.

4-8  6.  Conduct studies into the causes of the social problems with

4-9  which the Division is concerned.

4-10      7.  Invoke any legal, equitable or special procedures for the

4-11  enforcement of his orders or the enforcement of NRS 422.2352 to

4-12  422.2374, inclusive, 422.301 to 422.306, inclusive, 422.380 to

4-13  422.390, inclusive, and 422.580[.] , and sections 2 to 9, inclusive,

4-14  of this act.

4-15      8.  Exercise any other powers that are necessary and proper for

4-16  the standardization of state work, to expedite business, and to

4-17  promote the efficiency of the service provided by the Division.

4-18      Sec. 13.  NRS 422.301 is hereby amended to read as follows:

4-19      422.301  The Administrator and the Division of Health Care

4-20  Financing and Policy shall administer the provisions of NRS

4-21  422.2352 to 422.2374, inclusive, 422.301 to 422.306, inclusive,

4-22  422.380 to 422.390, inclusive, and 422.580, and sections 2 to 9,

4-23  inclusive, of this act, subject to administrative supervision by the

4-24  Director.

4-25      Sec. 14.  1.  The Division of Health Care Financing and

4-26  Policy of the Department of Human Resources shall begin assessing

4-27  fees pursuant to this act on July 1, 2003.

4-28      2.  A nursing facility does not owe a fee assessed pursuant to

4-29  this act until:

4-30      (a) The amendment to the State Plan for Medicaid which

4-31  increases the rates paid to nursing facilities for providing services

4-32  pursuant to the Medicaid program is approved by the Federal

4-33  Government; and

4-34      (b) The nursing facilities have been compensated retroactively at

4-35  the increased rate for services provided pursuant to the Medicaid

4-36  program on or after July 1, 2003.

4-37      Sec. 15.  1.  This section and section 7 of this act become

4-38  effective upon passage and approval.

4-39      2.  Sections 1 to 6, inclusive, and 8 to 14, inclusive, of this act

4-40  become effective:

4-41      (a) Upon passage and approval for the purpose of adopting

4-42  regulations; and

4-43      (b) On July 1, 2003, for all other purposes.

 

4-44  H