By Naishtat, Wohlgemuth, et al. H.B. No. 1001
77R11310 MCK-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the review of the reimbursement methodology for and
1-3 resource needs of nursing facilities.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. REVIEW OF REIMBURSEMENT RATES. (a) The Health
1-6 and Human Services Commission, in conjunction with the Texas
1-7 Department of Human Services, shall evaluate the methodology used
1-8 for determining Medicaid reimbursement rates for nursing
1-9 facilities. The commission and department shall:
1-10 (1) consider including legitimate costs of doing
1-11 business that are not currently included in the reimbursement rate;
1-12 and
1-13 (2) explore methods to adjust the reimbursement rate
1-14 to account for sudden increases in liability insurance rates and
1-15 other costs of doing business.
1-16 (b) The Health and Human Services Commission, in conjunction
1-17 with the Texas Department of Human Services, shall:
1-18 (1) evaluate the effectiveness of the Medicaid nursing
1-19 facility reimbursement rate methodology to provide incentives for
1-20 increased direct staffing;
1-21 (2) examine the possibility of adding incentives to
1-22 Medicaid reimbursement rates for increased spending to improve the
1-23 diet of residents and other increased spending to improve the
1-24 quality of care and quality of life for residents;
2-1 (3) examine the possibility of developing a system of
2-2 adjusted Medicaid reimbursement for nursing facilities that rewards
2-3 a higher level of performance based on quality indicators;
2-4 (4) examine any inadequacies of the current flat-rate
2-5 system in accounting for regional and facility-specific differences
2-6 in the cost of providing care and explore alternatives to the
2-7 flat-rate system that better account for those differences; and
2-8 (5) examine all the current methodology components,
2-9 including inflation factors and occupancy adjustments.
2-10 (c) In measuring the level of performance under Subsection
2-11 (b)(3) of this section, the criteria that should be examined should
2-12 include:
2-13 (1) a quality of care index that could include the
2-14 factors listed under Section 242.403(a), Health and Safety Code;
2-15 (2) a customer satisfaction index;
2-16 (3) a resolved complaint index; and
2-17 (4) any other criteria the commission considers
2-18 appropriate for examination.
2-19 SECTION 2. REVIEW OF TILE CLASSIFICATION SYSTEM. (a) The
2-20 Health and Human Services Commission, in conjunction with the Texas
2-21 Department of Human Services, shall evaluate the Texas Index for
2-22 Level of Effort classification system used to quantify the
2-23 intensity of the care needs of individuals in nursing facilities
2-24 and to assign daily reimbursement rates for that care to determine
2-25 whether the system accurately accounts for the care needs of
2-26 patients with dementia, including patients with Alzheimer's
2-27 disease.
3-1 (b) In conducting the evaluation of the Texas Index for
3-2 Level of Effort classification system, the Health and Human
3-3 Services Commission shall seek the input of relevant professionals
3-4 and other individuals or organizations with expertise in caring for
3-5 people with dementia, including Alzheimer's disease.
3-6 SECTION 3. REPORT TO LEGISLATURE. The Health and Human
3-7 Services Commission shall report the results of the evaluations
3-8 conducted under this Act to the governor, the lieutenant governor,
3-9 and the speaker of the house of representatives not later than
3-10 December 1, 2002.
3-11 SECTION 4. EFFECTIVE DATE. This Act takes effect September
3-12 1, 2001.