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) Subject to
1-6 the availability of funds, the Health and Human Services
1-7 Commission, in conjunction with the Texas Department of Human
1-8 Services, shall evaluate the methodology used for determining
1-9 Medicaid reimbursement rates for nursing facilities. The
1-10 commission and department shall:
1-11 (1) consider including legitimate costs of doing
1-12 business that are not currently included in the reimbursement rate;
1-13 and
1-14 (2) explore methods to adjust the reimbursement rate
1-15 to account for sudden increases in liability insurance rates and
1-16 other costs of doing business.
1-17 (b) The Health and Human Services Commission, in conjunction
1-18 with the Texas Department of Human Services, shall:
1-19 (1) evaluate the effectiveness of the Medicaid nursing
1-20 facility reimbursement rate methodology to provide incentives for
1-21 increased direct staffing;
1-22 (2) examine the possibility of adding incentives to
1-23 Medicaid reimbursement rates for increased spending to improve the
1-24 diet of residents and other increased spending to improve the
2-1 quality of care and quality of life for residents;
2-2 (3) examine the possibility of developing a system of
2-3 adjusted Medicaid reimbursement for nursing facilities that rewards
2-4 a higher level of performance based on quality indicators;
2-5 (4) examine and consider adopting a means of
2-6 mitigating recoupment from nursing homes that fail to meet the
2-7 direct care spending requirements but provide a higher quality of
2-8 care, based on indicators determined appropriate by the Health and
2-9 Human Services Commission;
2-10 (5) examine any inadequacies of the current flat-rate
2-11 system in accounting for regional and facility-specific differences
2-12 in the cost of providing care and explore alternatives to the
2-13 flat-rate system that better account for those differences; and
2-14 (6) examine all the current methodology components,
2-15 including inflation factors and occupancy adjustments.
2-16 (c) In measuring the level of performance under Subsection
2-17 (b)(3) of this section, the criteria that should be examined should
2-18 include:
2-19 (1) a quality of care index that could include the
2-20 factors listed under Section 242.403(a), Health and Safety Code;
2-21 (2) a customer satisfaction index;
2-22 (3) a resolved complaint index; and
2-23 (4) any other criteria the commission considers
2-24 appropriate for examination.
2-25 SECTION 2. REVIEW OF TILE CLASSIFICATION SYSTEM. (a)
2-26 Subject to the availability of funds, the Health and Human Services
2-27 Commission, in conjunction with the Texas Department of Human
3-1 Services, shall evaluate the Texas Index for Level of Effort
3-2 classification system used to quantify the intensity of the care
3-3 needs of individuals in nursing facilities and to assign daily
3-4 reimbursement rates for that care to determine whether the system
3-5 accurately accounts for the care needs of patients with dementia,
3-6 including patients with Alzheimer's disease.
3-7 (b) In conducting the evaluation of the Texas Index for
3-8 Level of Effort classification system, the Health and Human
3-9 Services Commission shall seek the input of relevant professionals
3-10 and other individuals or organizations with expertise in caring for
3-11 people with dementia, including Alzheimer's disease.
3-12 SECTION 3. REPORT TO LEGISLATURE. The Health and Human
3-13 Services Commission shall report the results of the evaluations
3-14 conducted under this Act to the governor, the lieutenant governor,
3-15 and the speaker of the house of representatives not later than
3-16 September 1, 2002.
3-17 SECTION 4. EFFECTIVE DATE. This Act takes effect September
3-18 1, 2001.
_______________________________ _______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 1001 was passed by the House on
April 25, 2001, by a non-record vote; and that the House concurred
in Senate amendments to H.B. No. 1001 on May 24, 2001, by a
non-record vote.
_______________________________
Chief Clerk of the House
I certify that H.B. No. 1001 was passed by the Senate, with
amendments, on May 17, 2001, by the following vote: Yeas 30, Nays
0, 1 present, not voting.
_______________________________
Secretary of the Senate
APPROVED: __________________________
Date
__________________________
Governor