HB 527-FN-A - AS INTRODUCED
2023 SESSION
23-0522
05/04
HOUSE BILL 527-FN-A
AN ACT relative to Medicaid reimbursement rates for certain assisted living facilities.
SPONSORS: Rep. Horgan, Straf. 1; Rep. Pitre, Straf. 1
COMMITTEE: Health, Human Services and Elderly Affairs
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ANALYSIS
This bill increases the medicaid reimbursement rate for certain small assisted living facilities, makes an appropriation to the department of health and human services for this amount, and directs the department to submit a report to the legislature regarding the effects of the rate increase.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
23-0522
05/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Three
AN ACT relative to Medicaid reimbursement rates for certain assisted living facilities.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Medicaid Reimbursement Rate For Small Assisted Living Facilities. For the biennium ending June 30, 2025, Medicaid reimbursement rates for assisted living facilities shall be increased to $115 per day for facilities with fewer than l6 beds and a Medicaid bed occupancy rate of 50 percent or higher.
2 Appropriation; Department of Health and Human Services.
I. The department of health and human services shall include in its biennial budget requests the costs of funding the Medicaid reimbursement rate for small assisted living facilities as provided in section 1 of this act.
II. The sum necessary to increase the Medicaid reimbursement rate to $115 per day for assisted living facilities with fewer than 16 beds and a Medicaid bed occupancy rate of 50 percent or higher is hereby appropriated to the department of health and human services for the biennium ending June 30, 2025. The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated.
3 Report. On or before January 1, 2024, the department of health and human services shall submit a report to the governor, the senate president, and the speaker of the house of representatives that identifies the number of assisted living facilities and Medicaid beds eligible for the Medicaid reimbursement rate increase established in this act. The report shall address the status of implementation and the effect of the rate increase on the ability of these facilities to meet the needs of this vulnerable population.
4 Effective Date. This act shall take effect July 1, 2023.
23-0522
Revised 2/8/23
HB 527-FN-A- FISCAL NOTE
AS INTRODUCED
AN ACT relative to Medicaid reimbursement rates for certain assisted living facilities.
FISCAL IMPACT: [ X ] State [ ] County [ ] Local [ ] None
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| Estimated Increase / (Decrease) | |||
STATE: | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
Appropriation | $0 | Indeterminable (see explanation below) | Indeterminable (see explanation below) | $0 |
Revenue | $0 | $0 | $0 | $0 |
Expenditures | $0 | $5.3 million general funds; $5.3 million federal funds | $5.3 million general funds; $5.3 million federal funds | $5.3 million general funds; $5.3 million federal funds |
Funding Source: | [ X ] General [ ] Education [ ] Highway [ X ] Other - Federal Funds | |||
METHODOLOGY:
This bill increases Medicaid reimbursement rates for assisted living facilities to $115 per day for facilities with fewer than 16 beds and a Medicaid bed occupancy rate of 50 percent or higher. The Department of Health and Human Services states that it is likely impermissible to implement disparate rates for Medicaid providers of the same class and that provide the same level of services. Accordingly, the Department anticipates that in order to implement the rate increase required by this bill, it would need to increase rates for all assisted living facilities, regardless of the number of beds and/or occupancy levels.
Currently, rates for assisted living facilities range from $56.88 to $95.41 per day, depending on the acuity level of the patients served by the facility. The Department states that increasing the rate to $115 per day across all facilities would increase annual Medicaid expenditures by approximately $10.6 million per year, of which half would be paid for with state general funds and half would be paid for with matching federal funds.
The bill contains open warrant language allowing for general funds to be spent as needed to accomplish the objectives of the bill. The bill does not contemplate the situation described above, in which total expenditures would be greater than those needed to raise rates for the targeted facilities alone. For this reason, it is unclear whether or not the warrant language would be interpreted as sufficient to cover the entire cost of the bill.
AGENCIES CONTACTED:
Department of Health and Human Services
| Date | Body | Type |
|---|---|---|
| Feb. 9, 2023 | House | Hearing |
| March 15, 2023 | House | Exec Session |
| Nov. 14, 2023 | House | Exec Session |
| Nov. 15, 2023 | House | Floor Vote |
Jan. 3, 2024: Inexpedient to Legislate: MA VV 01/03/2024 HJ 1 P. 55
Nov. 15, 2023: Committee Report: Inexpedient to Legislate HB527-FN-A 11/15/2023 (Vote 25-0; CC) HC 49 P. 13
Oct. 17, 2023: Executive Session: 11/14/2023 10:00 am LOB 210-211 HC 42
Sept. 5, 2023: Division III Work Session: 10/03/2023 10:00 am LOB 210-211 HC 36
May 18, 2023: Full Committee Work Session: 05/24/2023 10:00 am LOB 205-207
March 16, 2023: Retained in Committee
March 10, 2023: Executive Session: 03/15/2023 11:00 am LOB 210-211
March 8, 2023: Division III Work Session: 03/15/2023 09:45 am LOB 210-211
March 1, 2023: Division III Work Session: 03/07/2023 01:00 pm LOB 104
Feb. 16, 2023: Division III Work Session: 02/27/2023 01:00 pm LOB 210-211
Feb. 9, 2023: ==CANCELLED== Division III Work Session: 02/15/2023 01:00 pm LOB 210-211
Feb. 2, 2023: Division Work Session: 02/09/2023 11:30 am LOB 210-211
Feb. 2, 2023: Public Hearing: 02/09/2023 10:45 am LOB 210-211
Jan. 24, 2023: Vacated and Referred to Finance (Reps. Packard, Osborne): MA VV 01/24/2023 HJ 3 P. 25
Jan. 11, 2023: Introduced (in recess of) 01/05/2023 and referred to Health, Human Services and Elderly Affairs HJ 3 P. 19