Assembly Bill No. 395–Assemblyman Goldwater

 

CHAPTER..........

 

AN ACT relating to public welfare; providing for an assessment of a fee on certain facilities for intermediate care and on certain facilities for skilled nursing; requiring the Division of Health Care Financing and Policy of the Department of Human Resources to administer the provisions concerning the assessment; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

    Section 1.  Chapter 422 of NRS is hereby amended by adding

thereto the provisions set forth as sections 2 to 9, inclusive, of this

act.

    Sec. 2.  As used in sections 2 to 9, inclusive, of this act, unless

the context otherwise requires, the words and terms defined in

sections 3, 4 and 5 of this act have the meanings ascribed to them

in those sections.

    Sec. 3.  “Facility for intermediate care” has the meaning

ascribed to it in NRS 449.0038, but does not include:

    1.  A facility which meets the requirements of a general or any

other special hospital pursuant to chapter 449 of NRS;

    2.  A facility for intermediate care which limits its care and

treatment to those persons who are mentally retarded or who have

conditions related to mental retardation; or

    3.  A facility for intermediate care that is owned or operated

by the State of Nevada or any political subdivision of the State of

Nevada.

    Sec. 4.  “Facility for skilled nursing” has the meaning

ascribed to it in NRS 449.0039, but does not include a facility for

skilled nursing that is owned or operated by the State of Nevada or

any political subdivision of the State of Nevada.

    Sec. 5.  “Nursing facility” means a facility for intermediate

care or a facility for skilled nursing.

    Sec. 6.  1.  Each nursing facility that is licensed in this state

shall pay a fee assessed by the Division of Health Care Financing

and Policy to increase the quality of nursing care in this state.

    2.  To determine the amount of the fee to assess pursuant to

this section, the Division of Health Care Financing and Policy

shall establish a uniform rate per non-Medicare patient day that is

equivalent to 6 percent of the total annual accrual basis gross

revenue for services provided to patients of all nursing facilities

licensed in this state. For the purposes of this subsection, total

annual accrual basis gross revenue does not include charitable

contributions received by a nursing facility.

    3.  The Division of Health Care Financing and Policy shall

calculate the fee owed by each nursing facility by multiplying the

total number of days of care provided to non-Medicare patients by

the nursing facility, as provided to the Division pursuant to section

7 of this act, by the uniform rate established pursuant to

subsection 2.

    4.  A fee assessed pursuant to this section is due 30 days after

the end of the month for which the fee was assessed.

    5.  The payment of a fee to the Division of Health Care

Financing and Policy pursuant to sections 2 to 9, inclusive, of this

act is an allowable cost for Medicaid reimbursement purposes.

    Sec. 7.  1.  Each nursing facility shall file with the Division

of Health Care Financing and Policy each month a report setting

forth the total number of days of care it provided to non-Medicare

patients during the preceding month, the total gross revenue it

earned as compensation for services provided to patients during

the preceding month and any other information required by the

Division.

    2.  Each nursing facility shall file with the Division of Health

Care Financing and Policy any information required and

requested by the Division to carry out the provisions of sections 2

to 9, inclusive, of this act.

    Sec. 8.  1.  There is hereby created in the State Treasury the

Fund to Increase the Quality of Nursing Care, to be administered

by the Division of Health Care Financing and Policy.

    2.  The Fund to Increase the Quality of Nursing Care must be

a separate and continuing fund, and no money in the Fund reverts

to the State General Fund at any time. The interest and income on

the money in the Fund, after deducting any applicable charges,

must be credited to the Fund.

    3.  Any money received by the Division of Health Care

Financing and Policy pursuant to sections 2 to 9, inclusive, of this

act must be deposited in the State Treasury for credit to the Fund

to Increase the Quality of Nursing Care, and must be expended, to

the extent authorized by federal law, to obtain federal financial

participation in the Medicaid Program, and in the manner set

forth in subsection 4.

    4.  Expenditures from the Fund to Increase the Quality of

Nursing Care must be used only:

    (a) To increase the rates paid to nursing facilities for providing

services pursuant to the Medicaid Program and may not be used to

replace existing state expenditures paid to nursing facilities for

providing services pursuant to the Medicaid Program; and

    (b) To administer the provisions of sections 2 to 9, inclusive, of

this act. The amount expended pursuant to this paragraph must

not exceed 1 percent of the money received from the fees assessed

pursuant to sections 2 to 9, inclusive, of this act, and must not

exceed the amount authorized for expenditure by the Legislature

for administrative expenses in a fiscal year.

    5.  If federal law or regulation prohibits the money in the

Fund to Increase the Quality of Nursing Care from being used in

the manner set forth in this section, the rates paid to nursing

facilities for providing services pursuant to the Medicaid Program

must be changed:

    (a) Except as otherwise provided in paragraph (b), to the rates

paid to such facilities on June 30, 2003; or

    (b) If the Legislature or the Division of Health Care Financing

and Policy has on or after July 1, 2003, changed the rates paid to

such facilities through a manner other than the use of

expenditures from the Fund to Increase the Quality of Nursing

Care, to the rates provided for by the Legislature or the Division of

Health Care Financing and Policy.

    Sec. 9.  The Division of Health Care Financing and Policy

shall establish administrative penalties for the late payment by a

nursing facility of a fee assessed pursuant to sections 2 to 9,

inclusive, of this act.

    Sec. 10.  NRS 422.2352 is hereby amended to read as follows:

    422.2352  As used in sections 2 to 9, inclusive, of this act, NRS

422.2352 to 422.2374, inclusive, 422.301 to 422.306, inclusive, and

422.380 to 422.390, inclusive, unless the context otherwise requires,

“Administrator” means the Administrator of the Division of Health

Care Financing and Policy.

    Sec. 11.  NRS 422.2368 is hereby amended to read as follows:

    422.2368  The Administrator may adopt such regulations as are

necessary for the administration of NRS 422.2352 to 422.2374,

inclusive, 422.301 to 422.306, inclusive, 422.380 to 422.390,

inclusive, and 422.580[.] , and sections 2 to 9, inclusive, of this

act.

    Sec. 12.  NRS 422.2372 is hereby amended to read as follows:

    422.2372  The Administrator shall:

    1.  Supply the Director with material on which to base proposed

legislation.

    2.  Cooperate with the Federal Government and state

governments for the more effective attainment of the purposes of

this chapter.

    3.  Coordinate the activities of the Division of Health Care

Financing and Policy with other agencies, both public and private,

with related or similar activities.

    4.  Keep a complete and accurate record of all proceedings,

record and file all bonds and contracts, and assume responsibility for

the custody and preservation of all papers and documents pertaining

to his office.

    5.  Inform the public in regard to the activities and operation of

the Division, and provide other information which will acquaint the

public with the financing of Medicaid programs.

    6.  Conduct studies into the causes of the social problems with

which the Division is concerned.

    7.  Invoke any legal, equitable or special procedures for the

enforcement of his orders or the enforcement of NRS 422.2352 to

422.2374, inclusive, 422.301 to 422.306, inclusive, 422.380 to

422.390, inclusive, and 422.580[.] , and sections 2 to 9, inclusive,

of this act.

    8.  Exercise any other powers that are necessary and proper for

the standardization of state work, to expedite business, and to

promote the efficiency of the service provided by the Division.

    Sec. 13.  NRS 422.301 is hereby amended to read as follows:

    422.301  The Administrator and the Division of Health Care

Financing and Policy shall administer the provisions of NRS

422.2352 to 422.2374, inclusive, 422.301 to 422.306, inclusive,

422.380 to 422.390, inclusive, and 422.580, and sections 2 to 9,

inclusive, of this act, subject to administrative supervision by the

Director.

    Sec. 14.  1.  The Division of Health Care Financing and

Policy of the Department of Human Resources shall begin assessing

fees pursuant to this act on July 1, 2003.

    2.  A nursing facility does not owe a fee assessed pursuant to

this act until:

    (a) The amendment to the State Plan for Medicaid which

increases the rates paid to nursing facilities for providing services

pursuant to the Medicaid program is approved by the Federal

Government; and

    (b) The nursing facilities have been compensated retroactively at

the increased rate for services provided pursuant to the Medicaid

program on or after July 1, 2003.

    Sec. 15.  1.  This section and section 7 of this act become

effective upon passage and approval.

    2.  Sections 1 to 6, inclusive, and 8 to 14, inclusive, of this act

become effective:

    (a) Upon passage and approval for the purpose of adopting

regulations; and

    (b) On July 1, 2003, for all other purposes.

 

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