HB 5236 Summary

• Authorizes the Commissioner of Social Services to implement an acuity-based Medicaid nursing home facility case mix payment system to replace the current cost-based payment system, effective July 1, 2020.

• Requires the state plan amendment to include fiscal impact evaluations, facility-by-facility analyses, provisions for specialized care costs (dementia, Alzheimer's, ventilator use, HIV/AIDS, behavioral health), value-based performance incentives, phased implementation with rate reduction limits, and geographic rate differentials for Fairfield County facilities.

• Mandates the Commissioner submit the proposed Medicaid state plan amendment to legislative joint standing committees with cognizance over human services and appropriations prior to federal submission, with committees having 30 days to hold public hearings and provide approval, denial, or modifications.

• Requires the Commissioner to submit a comprehensive implementation report by January 1, 2021, evaluating all transition components to the joint standing committees.

• Expands the nursing home finance advisory committee's duties to assess the transition to case mix payment and evaluate nursing home quality, acuity, census, and staffing levels.