SSB 6062 - H AMDS TO H APP COMM AMD (H-2996.1/97)436 WITHDRAWN

By Representative Dyer 3-31-97

On page 34, strike lines 20 through 23 and insert Aprice, per peer group, shall be established at 115 percent of the median direct care cost per case mix unit.@

On page 34, after line 23, insert A(iv) A cost-based system in which payment to a facility shall be the facility=s allowable cost per case mix unit, adjusted for case mix up to a ceiling. The ceiling, per peer group, shall be established at 115 percent of the median direct care cost per case mix unit.

(v) A corridor-based system in which payment to a facility shall be the facility=s allowable cost per case mix unit adjusted for case mix up to the ceiling and no less than a floor. The floor, per peer group, shall be established at 90 percent of the median direct care cost per case mix unit. The ceiling, per peer group, shall be established at 115 percent of the median direct care cost per case mix unit.@

On page 34, strike lines 26 through 28 and insert AThe rates shall either be based on actual allowable expenditures, limited by a median plus percentage lid, or a price based on a percentage of the median industry-wide indirect care costs. Payments based on at least two percentages shall be modeled for both peer groups; metropolitan statistical area and non-metropolitan statistical area.@

On page 34, after line 28, insert A(d) The department shall provide all data, information, and specifications of the methods used in establishing the shadow case mix rates to the nursing home provider associations.@

EFFECT: Lists additional nursing home rate structures to be modeled by the DSHS during FY 1998 and requires DSHS to produce all information regarding how the shadow nursing home rates are set to the nursing home provider associations.

FISCAL IMPACT: None.