HB23-1228: Nursing Facility Reimbursement Rate Setting

• Increases supplemental Medicaid payments for performance-based care to 12% of total provider fees starting July 1, 2024, rising to 15% by July 1, 2026, based on quality of life, quality of care, and facility management measures.

• Mandates per diem rate increases of at least 10% for fiscal year 2023-24, 3% for 2024-25, and 1.5% for 2025-26, with adjustments based on audited cost data for efficiently operated Class I nursing facilities.

• Requires state department to initiate a process by July 1, 2023, to remove Medicare costs from provider rate calculations by July 1, 2026, and promulgate rules establishing the methodology.

• Establishes new financial reporting requirements for nursing facilities receiving Medicaid funds, including audited financial statements, related-party transaction details, and ownership information, with audit costs allowable as reimbursement expenses.

• Directs state department to develop a transition plan by July 1, 2026, defining nursing home reimbursement methodology through rulemaking while engaging stakeholders and submitting annual reports through November 1, 2026.

• Appropriates $30,509,457 in general funds and anticipates $31,754,740 in federal funds for the 2023-24 fiscal year to implement reimbursement changes.