CHAPTER 253
HB 359-FN – FINAL VERSION
02Jan2008… 2547h
05/15/08 1943s
04Jun2008… 2028cofc
04Jun2008… 2188eba
2008 SESSION
05/04
HOUSE BILL 359-FN
AN ACT relative to recovery of medical assistance from an estate, relative to the nursing facility quality assessment, and establishing an assessment on intermediate care facilities for the intellectually disabled.
This bill:
I. Limits recovery of assistance to property interests created on or after July 1, 2005. It also
limits recovery to the value of the interest held by the recipient of the assistance. The bill requires the department to provide written notice of the procedure for obtaining a hardship waiver and those persons who are exempt from recovery by state and federal law.
II. Expands the definition of nursing facility for purposes of collection of the nursing facility quality assessment and the assessment from certain nursing facilities.
III. Establishes the intermediate care facility for the intellectually disabled (ICF) quality assessment and establishes a separate account for such assessments in the office of the state treasurer.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
02Jan2008… 2547h
05/15/08 1943s
04Jun2008… 2028cofc
04Jun2008… 2188eba
07-1126
05/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Eight
AN ACT relative to recovery of medical assistance from an estate, relative to the nursing facility quality assessment, and establishing an assessment on intermediate care facilities for the intellectually disabled.
Be it Enacted by the Senate and House of Representatives in General Court convened:
253:1 Recovery of Assistance. Amend RSA 167:14-a, VI to read as follows:
VI.(a) For purposes of recovering the costs of medical assistance, the estate of a recipient shall include all property, real or personal, which at the time of a recipient's death was held by the recipient in joint tenancy with rights of survivorship, tenancy in common, or life estate[, without regard to the date that such title or interest was established.] for all such title or interest established on or after July 1, 2005. Recovery shall be limited to the value of the recipient's ownership interest and in no case shall such amount exceed the total amount of medical assistance provided to the deceased recipient, nor shall recovery extend to any interest in property, real or personal, for which a non-recipient owner paid fair market value at the time said ownership interest was acquired.
(b) No sooner than 45 days from the death of the recipient, the department shall provide the other joint owner or owners notice of the department's claim. Written notice shall include a description of all categories of individuals exempt from recovery by reason of familial status as allowed under 42 U.S.C. section 1396p(b)(2) and RSA 167:16-a, IV, as well as the availability and method of requesting a hardship waiver. Within 30 days of the receipt of notification of the department's claim, the joint owner or owners shall acknowledge receipt of the department's claim and, provided that there shall not be undue hardship imposed upon the surviving joint owner or owners, either tender an amount equal to the deceased recipient's interest in the identified property and/or financial instrument to the state of New Hampshire toward the deceased's medical assistance bill, but such amount shall not exceed the total amount of medical assistance provided to the deceased recipient, or enter into a binding agreement to make such payment as soon as is practicable. If the joint owner or owners refuse to acknowledge receipt of the department's claim or to tender payment or fail to fulfill the agreement to pay without good cause, as required by this paragraph, the commissioner may bring an action in superior court or probate court, as the case may be, to compel such payment. Nothing in this paragraph shall be interpreted or applied so as to violate RSA 167:16-a[, IV] or 42 U.S.C. section 1396p(b)(2)(A) and (B) prohibiting recovery when the recipient is survived by a spouse, minor children, or disabled children or when the recipient is survived by either siblings or children under certain circumstances.
253:2 Nursing Facility Quality Assessment; Definition of Nursing Facility. Amend RSA 84-C:1, V to read as follows:
V. “Nursing facility” means:
(a) A nursing facility as defined in RSA 151-E:2, V.
(b) A facility licensed as a specialty hospital and certified to receive federal reimbursement as a nursing facility.
253:3 Nursing Facility Quality Assessment; Collection and Deposit of Assessment. Amend RSA 84-C:5, I to read as follows:
I. Except as provided in RSA 84-C:5-a, the payments required by RSA 84-C:3 shall be made by electronic transfer of moneys to the state treasurer and deposited to the nursing facility trust fund established by RSA 151-E:14.
253:4 New Section: Deposit of Certain Assessments. Amend RSA 84-C by inserting after section 5 the following new section:
84-C:5-a Collection and Deposit of Assessment. Notwithstanding the provisions of RSA 84-C:5, the payments required by RSA 84-C:3 for a nursing facility as defined in RSA 84-C:1, V(b) shall be deposited to the state general fund.
253:5 Nursing Facility Quality Assessment; Contingency. Amend RSA 84-C:11, I(d) to read as follows:
(d) Any proceeds collected from nursing facilities as defined in RSA 84-C:1, V(a), from the nursing facility quality assessment established in this chapter are expended by the state or any state agency for any purpose other than funding nursing facility expenditures through the nursing facility trust fund under RSA 151-E:14.
253:6 Nursing Facility Trust Fund Established. Amend RSA 151-E:14 to read as follows:
151-E:14 Nursing Facility Trust Fund Established. There is hereby established the nursing facility trust fund for the receipts from nursing facilities as defined in RSA 84-C:1, V(a), from the nursing facility quality assessment under RSA 84-C:3, any federal financial participation received by the state as a result of expenditures funded by these nursing facility quality assessments, and the interest thereon. All of these funds shall be credited to and for the purposes of the nursing facility trust fund and shall not be used for any other purposes.
253:7 PAU 05-01-08-04-01; Department of Health and Human Services Nursing Services. Amend 2007, 262:1, PAU 05-01-08-04-01 as follows:
Fiscal Year 2008 Fiscal Year 2009
Strike out:
86 Cedarcrest Rates * $401,502 $401,502
Insert:
86 Cedarcrest Rates * $401,502 $761,502
Strike out:
88 CMRH Reimb Restructuring ** $1,000,000 $1,000,000
Insert:
88 CMRH Reimb Restructuring $1,781,000 $1,781,000
Strike out:
Total $375,348,115 $385,556,099
Insert:
Total $376,129,115 $386,697,099
Estimated Source of Funds for
Nursing Services
Strike out:
00 Federal Funds $182,415,696 $185,850,995
Insert:
00 Federal Funds $182,806,196 $186,421,495
Strike out:
07 Agency Income $36,015,294 $37,196,815
Insert:
07 Agency Income $35,756,544 $36,938,065
Strike out:
General Fund $76,601,890 $52,373,097
Insert:
General Fund $77,251,140 $53,202,347
Strike out:
Total $375,348,115 $385,556,099
Insert:
Total $376,129,115 $386,697,099
253:8 New Chapter; ICF-MR Assessment. Amend RSA by inserting after chapter 84-C the following new chapter:
CHAPTER 84-D
84-D:1 Definitions. In this chapter:
I. “Assessment” means the ICF-MR quality assessment imposed pursuant to this chapter.
II. “Assessment period” means a 3-month period beginning July 1, October 1, January 1, and April 1, of each year.
III. “Commissioner” means the commissioner of the department of revenue administration.
IV. “Net patient services revenues” means revenues earned on an accrual basis of accounting, net of deducted amounts for bad debts, charity care, and payer discounts, by an ICF-MR for services provided to residents as provided for in 42 C.F.R. 433.68(d)(1)(iii).
V. “ICF-MR” means an intermediate care facility for the mentally retarded.
84-D:2 Imposition of Fee. An assessment of 5.5 percent of net patient services revenues is hereby imposed on all ICF-MRs on the basis of patient days in each ICF-MR. The fee shall be implemented in accordance with the provisions of 42 C.F.R. part 433.
84-D:3 Assessment Due.
I. Each ICF-MR shall pay 100 percent of its ICF-MR quality assessment due and payable for the assessment period no later than the 15th day of the month following the assessment period. Notwithstanding any provision of law to the contrary, no penalty or interest shall be imposed for failure to make payment of the assessment when due if such payment is made on or before the last day of the month in which such payment is due.
II. If the return required by RSA 84-D:4 shows an additional amount of assessment to be due, such additional amount is due and payable at the time the return is due.
84-D:4 Returns. Every ICF-MR shall on or before the 10th day of the month following the expiration of the assessment period make a return to the commissioner and to the commissioner of the department of health and human services. The commissioner shall adopt rules, pursuant to RSA 541-A, relative to the form of such return and the date which it must contain for the correct computation of facility net patient services revenues and the assessment upon such amount. All returns shall be signed by the authorized representative of the ICF-MR, subject to the pains and penalties of perjury. If such return shows an overpayment of the assessment due, the commissioner shall refund or credit the overpayment to the ICF-MR.
84-D:5 Collection and Deposit of Assessment. There is hereby established a nonlapsing ICF-MR separate account in the office of the state treasurer. All funds collected under this chapter and any federal financial participation received by the state as a result of expenditures funded by the ICF-MR quality assessments, and the interest thereon, shall be deposited in this account. Moneys from the account shall not be expended by the state or any state agency for any purpose other than funding ICF-MR expenditures as provided in RSA 151-E:15-a.
84-D:6 Additional Returns. When the commissioner has reason to believe that an ICF-MR has failed to file a return or to include any part of its net patient services revenue in a filed return, the commissioner may require the ICF-MR to file a return or a supplementary return showing such additional information as the commissioner prescribes. Upon the receipt of the supplementary return, or if none is received within the time set by the commissioner, the commissioner may find and assess the amount due upon the information that is available. The making of such additional return does not relieve the ICF-MR of any penalty for failure to make a correct original return or relieve it from liability for interest imposed under RSA 21-J:28 or any other additional charges imposed by the commissioner. This section shall not be construed to modify the statute of limitations provided in RSA 21-J:29.
84-D:7 Extension of Time for Returns. For good cause, the commissioner may extend the time within which an ICF-MR is required to file a return, and if such return is filed during the period of extension no penalty or late filing charge may be imposed for failure to file the return at the time required by this chapter, but the ICF-MR shall be liable for interest and late payment charges as prescribed in RSA 21-J:28 or RSA 21-J:33. Failure to file the return during the period of the extension shall void the extension.
84-D:8 Records.
I. Every ICF-MR shall:
(a) Keep such records as may be necessary to determine the amount of its liability under this chapter.
(b) Preserve such records for the period of 3 years or until any litigation or prosecution hereunder is finally determined.
(c) Make such records available for inspection by the commissioner or his or her authorized agents, upon demand, at reasonable times during regular business hours.
II. Whoever violates the provisions of this section shall be subject to the penalties imposed under RSA 21-J:39.
84-D:9 Administration.
I. The commissioner shall adopt rules, pursuant to RSA 541-A, relative to:
(a) The administration of the ICF-MR quality assessment; and
(b) The recovery of any assessment, interest on assessment, or penalties imposed by this chapter or by RSA 21-J.
II. The commissioner may institute actions in the name of the state to recover any assessment, interest on assessment, additions to assessment, or penalties imposed by this chapter or by RSA 21-J.
III. In the collection of any overdue tax, penalties, or interest imposed by this chapter or by RSA 21-J, the commissioner may use all of the powers granted to tax collectors under RSA 21-J and RSA 80 for the collection of taxes.
84-D:10 Confidentiality of Records. Notwithstanding the provisions of RSA 21-J:14, the commissioner shall not be prohibited from providing information to the commissioner of health and human services with respect to the assessment imposed by this chapter, provided that the commissioner of health and human services and his or her agents and employees shall be subject to the provisions of RSA 21-J:14 with respect to any information provided by the commissioner.
84-D:11 Contingencies.
I. The ICF-MR quality assessment imposed by this chapter shall not be assessed, and no return shall be required to be made, upon the occurrence of any of the following events:
(a) Federal approval of the ICF-MR quality assessment established under this chapter or of any related state plan amendments or waivers is withdrawn.
(b) Collection of the assessment is rendered invalid by the decision of any court or administrative agency.
(c) Any proceeds from the ICF-MR quality assessment established in this chapter are expended by the state or any state agency for any purpose other than funding ICF-MR expenditures.
II. The commissioner of health and human services shall notify the commissioner of revenue administration of the occurrence of any of the contingencies in paragraph I.
III. The ICF-MR quality assessment under this chapter shall not be assessed or collected and payments authorized shall not be made until after the commissioner of health and human services certifies to the commissioner that the department of health and human services has obtained all necessary federal approvals.
253:9 New Section; Expenditure of Funds From ICF-MR Quality Assessment. Amend RSA 151-E by inserting after section 15 the following new section:
151-E:15-a Expenditure of Funds From ICF-MR Quality Assessment. Notwithstanding any other provision of law, moneys from the ICF-MR quality assessment under RSA 84-D:3 and any federal financial participation received by the state as a result of expenditures funded by these ICF-MR quality assessments, and the interest thereon shall be paid out no less frequently than on a quarterly basis and shall be disbursed as follows:
I. The moneys shall be used to eliminate or reduce to the maximum extent possible the difference between the allowable medicaid costs, derived from the ICF-MR medicaid rate setting system, which ICF-MRs incur in providing care to medicaid residents, and the amount which the state has budgeted in order to fund that care.
II. If after the disbursement required in paragraph I there are still any moneys remaining from the ICF-MR quality assessment and any federal financial participation and the interest thereon, the ICF-MR rate setting system shall be adjusted to insure that all moneys are expended for ICF-MR care.
253:10 New Subparagraph; Separate Accounts. Amend RSA 6:12, I(b) by inserting after subparagraph (268) the following new subparagraph:
(269) Moneys deposited in the ICF-MR separate account established in RSA 84-D:5.
253:11 Applicability. The provisions of sections 2-7 of this act shall apply for the fiscal year ending June 30, 2008 and each fiscal year thereafter.
253:12 Replace “ICF-MR” with “ICF” and “Mentally Retarded” with “Intellectually Disabled.” Replace all references to “ICF-MR” with “ICF” and all references to “mentally retarded” with “intellectually disabled” in the section heading and in RSA 84-D as inserted by section 8 of this act; the section heading and RSA 151-E:15-a as inserted by section 9 of this act; and RSA 6:12, I(b)(269) as inserted by section 10 of this act.
253:13 Effective Date.
I. Section 1 of this act shall take effect 60 days after its passage.
II. Sections 2-7 and section 11 of this act shall take effect upon its passage.
III. Section 12 of this act shall take effect July 11, 2008.
IV. The remainder of this act shall take effect 60 days after its passage.
Approved: June 26, 2008
Effective Date: I. Section 1 shall take effect August 25, 2008.
II. Sections 2-7 and 11 shall take effect June 26, 2008.
III. Section 12 shall take effect July 11, 2008.
IV. Remainder shall take effect August 25, 2008.