BILL REQ. #:  H-2162.1 

Read first time 02/23/09.   Referred to Committee on Health & Human Services Appropriations.

     AN ACT Relating to nursing home medicaid reimbursement rate setting in nonurban counties; and amending RCW 74.46.533.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1   RCW 74.46.533 and 2007 c 508 s 6 are each amended to read as follows:
     (1) For the purposes of comparison, the department shall determine the following during the rate-setting periods for fiscal years 2008 and 2009; and for nonurban county nursing care facilities only, for rate-setting periods commencing July 1, 2009:
     (a) Each facility's June 30, 2007, combined rate for the direct care, support services, therapy, and operations components, less the quality maintenance fee; and
     (b) Each facility's estimated rebased rates for the July 1, 2007, and July 1, 2008, rate-setting periods, for the direct care, support services, therapy, and operations rate components, less the quality maintenance fee, adjusted for economic trends and conditions under the 2007-2009 biennial appropriations act; and
     (c) Effective July 1, 2009, and for each rate-setting period thereafter, each nonurban county facility's estimated rebased rates for the direct care, support services, therapy, and operations rates components, less the quality maintenance fee, adjusted for economic trends and conditions under the current applicable biennial appropriations act.
     (2) For the 2007-2009 fiscal biennium, the department shall include a "hold harmless" provision after rebasing to 2005 costs for the July 1, 2007, through June 30, 2008, rate-setting period and the July 1, 2008, through June 30, 2009, rate-setting period. Commencing with the July 1, 2009, rate-setting period the department shall include a "hold harmless" provision only for nonurban county nursing care facilities. This "hold harmless" provision shall apply to facilities that meet both of the following conditions:
     (a) Facilities whose estimated rebased rates calculated under subsection (1)(b) or (c) of this section are less than their June 30, 2007, rates calculated under subsection (1)(a) of this section; and
     (b) Facilities whose combined adjusted costs per adjusted resident day in the direct care, support services, therapy, and operations cost centers were greater than the combined per resident day reimbursement rates for these cost centers in either calendar years 2004 or 2005.
     For those facilities that meet the conditions in this subsection, the "hold harmless" provision shall ensure that for the July 1, 2007, through June 30, 2008, rate-setting period and for the July 1, 2008, through June 30, 2009, rate-setting period, the department shall set each facility's component rates in direct care, support services, therapy, and operations to the facility's June 30, 2007, rate, less the quality maintenance fee, adjusted for economic trends and conditions specified in the 2007-2009 biennial appropriations act. For nonurban county nursing care facilities that meet the conditions in this subsection, the "hold harmless" provision shall ensure that for the July 1, 2009, and following period rate settings, the department shall set each such facility's component rates in direct care, support services, therapy, and operations to not less than the facility's June 30, 2007, rate, less the quality maintenance fee, adjusted additionally for economic trends and conditions specified in the biennial appropriations acts since June 30, 2007.