SUMMARY OF BILL
REPORTED FROM COMMITTEE
The bill would amend the Social Welfare Act to specify that, except as provided by the bill, if the Department of Health and Human Services issued a new interpretation of existing Medicaid provider policy directly affecting nursing facility Medicaid cost reports, that change in policy would have to have a prospective effective date. A policy could have a retrospective effective date as part of a State plan amendment approval or waiver approval, or if required by State law, Federal law, or judicial ruling.
The bill would bar retrospective Medicaid provider policies that affected nursing facility cost reports unless those policies were required to be retrospective as part of a Federal Medicaid policy approval process or required by State law, Federal law, or judicial ruling. This would lead to potential unrealized retrospective positive and negative fiscal impacts. The nursing facility rate setting process creates an effective time limitation on retrospective policies and there are few significant Medicaid policy changes that are not tied to Federal policy determinations or legal restrictions; therefore, the number and magnitude of these now barred retrospective policy changes would be limited. As such, the bill would have a minor fiscal impact.
This analysis was prepared by nonpartisan Senate staff for use by the Senate in its deliberations and does not constitute an official statement of legislative intent.