HI HCR192

Request the Department of Human Services to study compliance with regulatory requirements for Medicaid nursing facility level of care clients enrolled in the QUEST Expanded Access (QExA) Program across all care settings.

Study scope includes compliance with the Balanced Budget Act of 1997 (42 C.F.R. Part 438), DHS Med-QUEST Division contract requirements, Med-QUEST Quality Strategy, and Med-QUEST Quality Standards.

Examine whether certified nursing home level of care clients are fully informed of and have their rights to complaints, grievances, and appeals protected in home and community-based settings, including private homes, case management agencies, community care foster family homes, expanded residential care homes, and assisted living facilities.

Review case management agency contracts, QExA-contracted provider compliance, Community Ties of America's monitoring processes, and notification and implementation of member rights across all care settings.

Department of Human Services shall submit study report with findings, recommendations, and any necessary implementing legislation to the Legislature no later than 20 days before the 2014 Regular Session convening.