Revision: March 8, 2012, midnight
SB 321-FN – AS AMENDED BY THE SENATE
03/07/12 0876s
2012 SESSION
01/04
SENATE BILL 321-FN
AN ACT establishing a committee to study the continuation of payments to long-term care facilities.
SPONSORS: Sen. Forrester, Dist 2; Sen. Bradley, Dist 3; Sen. De Blois, Dist 18; Sen. Sanborn, Dist 7; Sen. Lambert, Dist 13; Rep. Reagan, Rock 1; Rep. Pilliod, Belk 5; Rep. Millham, Belk 5; Rep. Greemore, Belk 3; Rep. Cebrowski, Hills 18
COMMITTEE: Health and Human Services
This bill establishes a committee to study the continuation of payments to long-term care facilities.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
03/07/12 0876s
12-2989
01/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twelve
AN ACT establishing a committee to study the continuation of payments to long-term care facilities.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Committee Established. There is established a committee to study the continuation of payments to long-term care facilities.
2 Membership and Compensation.
I. The members of the committee shall be as follows:
(a) Three members of the senate, appointed by the president of the senate.
(b) Three members of the house of representatives, appointed by the speaker of the house of representatives.
II. Members of the committee shall receive mileage at the legislative rate when attending to the duties of the committee.
3 Duties. The committee shall study the continuation of payments to long-term care facilities. Specifically, the committee shall include in its study:
I. Whether the maximum extent permissible under federal law, providing for Medicaid payments at the applicable daily rate should begin no later than 45 days after a resident applies for Medicaid.
II. What provisions need to be put in place to allow facilities to appeal Medicaid eligibility determinations.
III. The proper administration of RSA 151-E.
4 Chairperson; Quorum. The members of the study committee shall elect a chairperson from among the members. The first meeting of the committee shall be called by the first-named senate member. The first meeting of the committee shall be held within 30 days of the effective date of this section. Four members of the committee shall constitute a quorum.
5 Report. The committee shall report its findings and any recommendations for proposed legislation to the president of the senate, the speaker of the house of representatives, the senate clerk, the house clerk, the governor, and the state library no later than 90 days after the effective date of this act.
6 Effective Date. This act shall take effect upon its passage.
LBAO
12-2989
12/21/11
SB 321-FN - FISCAL NOTE
AN ACT establishing a committee to study the continuation of payments to long-term care facilities.
FISCAL IMPACT:
The New Hampshire Association of Counties states this bill may increase state and county revenues, and state expenditures by an indeterminable amount in FY 2013 and in each year thereafter. There will be no fiscal impact on local revenue, or county and local expenditures.
METHODOLOGY:
The New Hampshire Association of Counties indicates this bill addresses the issue of non-reimbursement or late reimbursement of county nursing home costs by the Medicaid program by requiring Medicaid reimbursements to begin no later then 45 days after a resident applies for Medicaid, and allowing the nursing facilities to appeal Medicaid eligibility determinations.
The Association states, in October 2010, the average length of time for pending Medicaid applications in individual county nursing homes ranged from 3 months to 10 months, and the number of applications in the nursing homes ranged from 3 applications to 30. While the application is pending the nursing home cannot discharge the resident and must fund all of the costs until Medicaid eligibility is determined and the home is reimbursed by the Medicaid program. The Association states to the extent Medicaid eligibility would be determined faster, county revenue from reimbursements would be received closer to the time the services are actually provided. In addition, the Association states the bill allows nursing homes to appeal Medicaid non-eligibility determinations. The Association states nursing homes provide services without reimbursement for residents determined ineligible for Medicaid. The Association estimates the denials amounted to almost $2 million in costs from March 2010 to October 2011. The Association indicates county revenue would increase if non-eligibility decisions were reversed but cannot estimate the potential fiscal impact.
The Department of Health and Human Services states this bill requires the department to adopt rules to ensure Medicaid payments are made at the applicable daily rate no later than 45 days after a resident applies for Medicaid and also allows nursing facilities to appeal Medicaid eligibility determinations. The Department states the bill will not result in increased costs or savings to the state since the bill does not change medical or financial eligibility or the date of eligibility. If all eligibility requirements are met eligibility begins on the date of application and up to three months of retroactive Medicaid coverage may be requested. The Department provides the following assumptions:
• The Department is not able to determine the percentage of applicants who will be ineligible for Medicaid;
• In order for Medicaid payments to be made within 45 days from the date of application, financial and medical eligibility would need to be determined and a properly completed claim would need to be submitted by the facility;
• Payments are currently made 7-14 days after a claim is received. In order to meet the 45-day timeframe, the medical and financial eligibility determinations would have to be completed in less than 30 days; and
• A significant number of eligibility determinations are complicated by required review of trusts, annuities, and asset transfers made within the past 60 months. Some applicants are assessed a penalty period of ineligibility for transferring assets for less than fair market value.