1908‑S2 AMH DYER SANC 4

2SHB 1908 ‑ H AMD

By Representative Dyer

     On page 6, after line 24, add a new section as follows

     "NEW SECTION. Sec. 6.  A new section is added to chapter 74.42 RCW to read as follows:

     A nursing facility shall not admit any individual who is medicaid eligible unless that individual has been assessed by the department.  Appropriate hospital discharge shall not be delayed pending the assessment.

     To ensure timely hospital discharge of medicaid eligible persons, the date of the request for a department long-term care assessment shall be deemed the effective date of the initial service and payment authorization.  The department shall respond promptly to such requests.

     A nursing facility admitting an individual without a request for a department assessment shall not be reimbursed by the department and shall not be allowed to collect payment from a medicaid eligible individual for any care rendered before the date the facility makes a request to the department for an assessment.  The date on which a nursing facility makes a request for a department long-term care assessment shall be deemed the effective date of initial service and payment authorization for admissions regardless of the source of  referral.

     A medicaid eligible individual residing in a nursing facility who is transferred to an acute care hospital shall not be required to have a department assessment under this section prior to returning to the same or another nursing facility."

Renumber the sections consecutively, correct internal references and correct the title.

EFFECT:  Facilitates the ability for nursing homes to accept a medicaid eligible patient with uncertain eligibility and encourages the Department of Social and Health Services to respond promptly to patient assessments.  Establishes that the specific request date for patient assessment is the effective payment date if medicaid eligibility is established.  Clarifies that a medicaid eligible patient transferred to a  nursing facility from a hospital a second time does not need to be assessed again.