HB5294 Summary

• Establishes medically complex for the developmentally disabled (MC/DD) facilities as licensed facilities under the MC/DD Act, replacing references to long-term care facilities for persons under 22 years of age.

• Sets Medicaid reimbursement rates for MC/DD facilities starting July 1, 2018: minimum base rate of $216 per diem, with tiered exceptional care rates of $255 (Tier 1), $569 (Tier 2), and $765 (Tier 3) based on resident medical complexity.

• Requires MC/DD facilities to document resident medical conditions and services in medical records using Minimum Data Set (MDS) standards to qualify for exceptional care reimbursement rather than submitting MDS assessments to the Department.

• Transfers reimbursement responsibility and appropriations for MC/DD facilities from the Department of Human Services to the Department of Healthcare and Family Services effective July 1, 2018.

• Imposes assessment and licensing fees on MC/DD facilities beginning July 1, 2018, with revenues deposited into a new Medically Complex for the Developmentally Disabled Provider Fund for facility payments and administrative expenses.