HB 21-1227 Summary

• State Department must develop and enforce a "demonstration of need" requirement for new nursing facility providers seeking Medicaid certification, excluding facilities certified before June 30, 2021.

• Demonstration of need must consider state demography data, facility quality and performance metrics, business solvency information, input from multiple state departments and local governments, and innovative practices of the requesting facility.

• State Board must promulgate rules by June 30, 2022 establishing certification criteria, with public input gathered from disability advocacy organizations, urban and rural facility providers, aging advocacy groups, and nursing facility trade organizations.

• Medicaid certification decisions must comply with the Olmstead v. L.C. Supreme Court decision and encourage appropriate resource allocation, alternative service delivery methods, and least restrictive care settings.

• Replaces "Resource Utilization Groups" terminology with "Case-Mix Group" system for classifying nursing facility residents by clinical and functional status, and allows state to exempt facilities with five or fewer Medicaid beds from standard reimbursement methodology.