SB 42

Abstract

Creates the Nursing Home Reform Act. Provides that the purposes of the Act include establishing a framework for the provision of care to residents of facilities licensed under the Nursing Home Care Act, ensuring the coordination of regulation and reimbursement, strengthening the provider and employee community, and supporting the highest possible quality of resident-centered services and care. Effective immediately. Senate Committee Amendment No. 1 Replaces everything after the enacting clause. Creates the Nursing Home Medicaid Reimbursement Reform Act. Provides that it shall be a matter of State policy that all residents of facilities licensed under the Nursing Home Care Act who meet the financial requirements for medical assistance and have a determination of need score of 29 or greater shall be guaranteed the right to: (1) select the facility in which he or she receives care; (2) participate fully in the development of his or her individualized care plan; and (3) be informed in advance of any changes to his or her individualized care plan or to the status of his or her nursing home stay. Provides that all medical treatment and services deemed medically necessary by a physician licensed to practice medicine in all of its branches, including the provision of prescription drugs not covered under a qualified Medicare Part D Prescription Drug Plan, shall be presumed to be available for any resident who is eligible for medical assistance and shall qualify for reimbursement under the Medical Assistance Program. Provides that any medical services provided, as specified in the Act, to a resident of a facility licensed under the Nursing Home Care Act shall be reimbursed based on an aggregate rate composed of nursing, support, and capital components. Provides that the State shall also reimburse each facility paying property taxes an amount that equals the facility's actual property tax bill, if applicable. Provides that any additional funds contained in the State Fiscal Year 2020 budget in excess of those expended in the State Fiscal Year 2019 budget shall be distributed by statute. Provides that reimbursement payments for services covered under the Act are due and payable on the last day of each month for all claims submitted during the preceding calendar month. Effective immediately.