HB 6446 Summary

• Medicaid Third-Party Recovery: Establishes procedures for the Department of Social Services to pursue recovery from third-party insurers for medical costs paid on behalf of Medicaid recipients; requires claims be submitted within three years and enforced within six years, with insurers given 90 days to respond or face uncontestable payment obligations.

• Nursing Home Reimbursement Shift: Transitions nursing home payment methodology from the current system to an acuity-based (case-mix adjusted) system effective October 1, 2021, with quarterly updates and cost-neutral transition based on fiscal year 2018 data.

• Nursing Home Rate Constraints: Implements rate-setting limits for nursing homes including maximum percentages of median costs (135% for direct care, 115% for indirect costs) and freezes inflation-based rate increases through June 30, 2023.

• Insurance Equity Requirements: Prohibits health insurers from denying coverage or limiting benefits based on an individual's Medicaid eligibility; prevents differential treatment of the state Medicaid agency compared to other insurance assignees.

• Independent Living Facility Exemption: Authorizes New Horizons, Inc. to construct and operate an independent living facility for severely disabled adults in Farmington with tax-exempt bond financing and state supplement program payments.