Bill to prevent new methodology for Medicaid rate changes advanced

A bill that would require the state Department of Health and Human Services to keep its Medicaid reimbursement rate methodology within its existing rules and regulations process advanced from general file July 27.

<a href='http://news.legislature.ne.gov/dist36' target='_blank' title='Link to the website of Sen. Matt Williams'>Sen. Matt Williams</a>
Sen. Matt Williams

LB1053, introduced by the Health and Human Services Committee, would clarify that any change to the methodology is considered substantive and would require rule and regulation-making proceedings under the Administrative Procedure Act.

Sen. Matt Williams of Gothenburg introduced the bill on behalf of the committee. He said the rate methodology is used to calculate the amount of reimbursement that nursing facilities and hospitals receive for the care of Medicaid patients.

The department announced last year that it would remove the reimbursement rate methodology from its rules and regulations process, he said, and that it had developed a new flat-rate methodology to calculate the Medicaid reimbursement amount for nursing facilities.

“Many of our offices were flooded with calls, not only from nursing home administrators but also from hospital administrators, who were extremely concerned that the removal of the rate methodologies without their involvement would lead to unintended consequences,” Williams said. “Not having the rate methodology implemented through a formal public process introduced too much uncertainty.”

Williams said the bill would address a “crisis” that could cause some nursing homes to deny care to Medicaid recipients.

A committee amendment, adopted 34-0, added provisions of two bills—LB833, introduced by Sen. Sue Crawford of Bellevue, and LB1043, introduced by Blair Sen. Ben Hansen.

LB833 would allow Programs of All-Inclusive Care for the Elderly (PACE) facilities that meet DHHS licensure requirements to operate multiple centers under one license. LB1043 would make several changes to state law governing receiverships of health care facilities, including reducing from 12 months to six the time allowed to terminate a receivership and requiring the closure or sale of a health care facility within 60 days of a court order.

Senators advanced LB1053 to select file on a 47-0 vote.

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