TO: | Honorable Warren Chisum, Chair, House Committee on Appropriations |
FROM: | John S. O'Brien, Director, Legislative Budget Board |
IN RE: | HB3778 by Rose (Relating to the creation and administration of a quality assurance fee for nursing facilities; providing an administrative penalty.), Committee Report 1st House, Substituted |
Fiscal Year | Probable Net Positive/(Negative) Impact to General Revenue Related Funds |
---|---|
2008 | ($642,880) |
2009 | $0 |
2010 | $0 |
2011 | $0 |
2012 | $0 |
Fiscal Year | Probable Revenue Gain/(Loss) from New General Revenue Dedicated |
Probable Savings/(Cost) from New General Revenue Dedicated |
Probable Savings/(Cost) from GR MATCH FOR MEDICAID 758 |
Probable Revenue Gain/(Loss) from FEDERAL FUNDS 555 |
---|---|---|---|---|
2008 | $111,305,000 | ($36,871,723) | ($642,880) | $57,878,480 |
2009 | $225,474,000 | ($74,696,782) | $0 | $112,232,103 |
2010 | $228,775,000 | ($74,696,782) | $0 | $112,232,103 |
2011 | $232,255,000 | ($74,696,782) | $0 | $112,232,103 |
2012 | $235,918,000 | ($74,696,782) | $0 | $112,232,103 |
Fiscal Year | Probable Savings/(Cost) from FEDERAL FUNDS 555 |
---|---|
2008 | ($57,878,480) |
2009 | ($112,232,103) |
2010 | ($112,232,103) |
2011 | ($112,232,103) |
2012 | ($112,232,103) |
The bill would provide that a quality assurance fee (QAF) is imposed on each institution subject to this subchapter for which a license fee must be paid under Section 242.034 (relating to convalescent and nursing homes and related institutions). The bill would provide that this subchapter does not apply to a certain facilities.
The bill would require the Health and Human Services Commission (HHSC) to establish the QAF for each patient day in an amount that will produce annual revenues of not more than 5.5 percent of the institution’s total annual gross receipts in this state.
The bill would provide that the QAF is an allowable cost for reimbursement under the state Medicaid program. The bill would prohibit a nursing facility from listing the QAF as a separate charge on a patient’s or resident’s billing statement or otherwise directly or indirectly attempting to charge the QAF to a patient or resident. The bill would require HHSC or DADS as directed by the executive commissioner to collect the QAF.
The bill would authorize the executive commissioner to adopt rules granting exceptions from the QAF, including and exception for units of service reimbursed through Medicare Part A, if HHSC obtains all waivers necessary under federal law. The bill would prohibit an administrative penalty assessed under this subchapter in accordance with Section 242.066 from exceeding one-half of the amount of the outstanding QAF or $20,000, whichever is greater.
The bill would establish the nursing home quality assurance fee account as a dedicated account in the general revenue fund, and require that interest earned on money in the account be credited to the account.
The bill would require money in the account, together with federal matching money, subject to legislative appropriation and this subchapter, to be used to support or maintain an increase in Medicaid reimburse for institutions. The bill would authorize HHSC, subject to legislative appropriation, to use money in the nursing home quality assurance fee account, together with any federal money available to match that money, to: offset allowable expenses under the state Medicaid program; and increase reimbursement rates paid under the Medicaid program to institutions.
The bill would prohibit the quality assurance fee from being imposed or collected until the amendment to the state plan for Medicaid that increases rates paid to nursing facilities is approved by the federal government, and nursing facilities have been compensated retroactively at the increased rate for the period beginning with the effective date of the bill.
This bill would create a dedicated account in the General Revenue Fund, or create a dedicated revenue source. Therefore, the fund, account, or revenue dedication included in the bill would be subject to the funds consolidation review by the current Legislature.
Source Agencies: | 304 Comptroller of Public Accounts, 529 Health and Human Services Commission, 539 Aging and Disability Services, Department of
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LBB Staff: | JOB, CT, JI, JJ
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