HB4678 Summary

• Prohibits nurse agencies from requiring covenants not to compete with nurses and certified nurse aides; voids any existing such agreements.

• Caps supplemental healthcare staffing agency billing to health care facilities at 130% of employee total compensation plus payroll taxes, with quarterly reporting to Department of Employment Security.

• Implements Patient Driven Payment Model (PDPM) for nursing facility Medicaid reimbursement effective January 1, 2022, with statewide base rate of at least $90.25 and variable per diem add-ons based on facility staffing levels.

• Establishes directed quality improvement payments of at least $70,000,000 annually to nursing facilities based on Centers for Medicare and Medicaid Services star ratings and establishes CNA tenure and promotion wage increment payments.

• Creates new tiered long-term care provider assessment structure beginning January 1, 2022, varying from $7 to $22.40 per Medicaid resident day based on facility size; schedules repeal of nursing home license fee article for July 1, 2024.