HB 1302 -- MEDICAID NURSING HOME REIMBURSEMENT

SPONSOR:  Lager

COMMITTEE ACTION:  Voted "do pass" by the Committee on Senior
Security by a vote of 17 to 0.

This bill creates the Elder Care Protection Act of 2004 and
requires the Division of Medical Services in the Department of
Social Services to annually recalculate the Medicaid per diem
reimbursement rate of each nursing home facility participating as
a provider in the Medicaid Program.  The bill:

(1)  Requires the recalculation to be performed over three state
fiscal years and in three separate payments beginning July 1,
2004;

(2)  Requires the recalculation to be based on a facility's
reported costs which are filed with the department, beginning
with the facility's fiscal year ending in 2001; and

(3)  Prohibits the division from applying a minimum utilization
adjustment factor to a recalculation.

The bill contains provisions pertaining to the factors used in
the recalculations which begin July 1, 2004.  Effective July 1,
2007, each facility will receive a full Medicaid recalculation
based on its 2004 Medicaid cost report of adjusted costs.

The bill contains an emergency clause.

FISCAL NOTE:  Estimated Net Cost to General Revenue Fund of
$16,485,910 to $16,895,380 in FY 2005, $38,028,911 to $38,545,345
in FY 2006, and $64,715,396 to $65,321,035 in FY 2007.  No impact
on Other State Funds in FY 2005, FY 2006, and FY 2007.

PROPONENTS:  Supporters say that currently Medicaid is
reimbursing nursing homes at the 1992 rate.  The low rate is
placing a large burden on elderly care.  Homes are in disrepair,
resident care is lacking, and wages are too low.  An increase in
the per diem is necessary for the proper care of seniors.

Testifying for the bill were Representatives Lager and Brooks;
Missouri Health Care Association; Department of Health and Senior
Services; Office of the Lieutenant Governor; Lutheran Senior
Services; Missouri Association of Homes for the Aging; and
Bethesda Health Services.

OPPONENTS:  There was no opposition voiced to the committee.

Bob Dominique, Legislative Analyst

Missouri House of Representatives
92nd General Assembly, 2nd Regular Session
Last Updated September 23, 2004 at 11:15 am