MI SB1037

New interpretations of existing Medicaid provider policy affecting nursing facility cost reports must have a prospective effective date, unless required by state plan amendment, waiver approval, or state/federal law or judicial ruling.

Department must revise the Medicaid nonavailable bed plan policy by October 1, 2019 to allow nursing facilities to remove beds from service for up to 5 years, with flexible room and bed placement options while keeping the entire facility usable.

Department must automatically update program enrollment and managed care status in CHAMPS when a health maintenance organization files to disenroll a nursing facility resident after 45 days of skilled care.

Department must conduct a secondary review of denied rate exceptions within 60 days upon nursing facility request, performed by separate staff from those who made the initial determination.

Department shall hold quarterly meetings with nursing facility stakeholders to establish advisory workgroups addressing cost report audit improvements, transparency in regulatory application, and enhanced communication between providers and department staff.