SB 281 — AN ACT CONCERNING PENALTIES FOR UNAUTHORIZED USE OF RATE INCREASES EARMARKED FOR STAFF WAGE ENHANCEMENTS AT NURSING HOME FACILITIES.

Senate General Assembly FileRaised Bill No.

151281 February Session, 2022 SenateLCO Bill No.

2812456 Senate,Referred Marchto 28, 2022 The Committee on HumanHUMAN ServicesSERVICES reportedIntroduced throughby: SEN.

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AN ACT CONCERNING PENALTIES FOR UNAUTHORIZED USE OF RATE INCREASES EARMARKED FOR STAFF WAGE ENHANCEMENTS AT NURSING HOME FACILITIES.

(b) The department, in its sole discretion, may enter into a SB281recoupment /schedule Filewith a nursing home facility so as not to LCO 2456 \\PRDFS1\SCOUSERS\FORZANOF\WS\2022SB-00281-R01 of 2 SB.docx Raised Bill No.

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151 recoupment schedule with a nursing home facility so as not to negatively impact patient care.

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151 2 SB281 File No.

151 The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose.

In general, fiscal impacts are based upon a variety of informational sources, including the analyst’s professional knowledge.

Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note State Impact:

Agency Affected Fund-Effect FY 23 $ FY 24 $ Resources of the General Fund GF - Potential See Below See Below Revenue Gain Note:

GF=General Fund Municipal Impact:

None Explanation The bill could result in a revenue gain to the state by allowing the Department of Social Services (DSS) to assess civil penalties on nursing homes for the improper use of increased funding meant for wage enhancements for facility employees.

While effective from passage, the provisions of the bill apply to funding for nursing home wage increases included in the FY 22-23 biennial budget ($47.3 million in FY 22 and $102.2 million in FY 23).

Audits of this funding are not anticipated until late FY 23 and/or FY 24 after cost reports are filed, and therefore any associated revenue from potential fines cannot be determined at this time.

Civil penalties are limited to 50% of the total amount received for the rate increase but not used for wage enhancements for facility employees.

The Out Years The annualized ongoing fiscal impact is dependent on the potential for civil penalties as described above.

SB281 / File No.

151 3 SB281 File No.

151 OLR Bill Analysis SB 281 AN ACT CONCERNING PENALTIES FOR UNAUTHORIZED USE OF RATE INCREASES EARMARKED FOR STAFF WAGE ENHANCEMENTS AT NURSING HOME FACILITIES.

SUMMARY This bill allows the Department of Social Services (DSS) to assess a civil penalty on a nursing home that receives a rate increase to enhance itsemployees’ wagesbut failsto use it forthatpurpose.

The civilpenalty is in addition to any applicable recoupment or rate decrease the law otherwise allows.

Before assessing a civil penalty, the bill requires DSS to complete a department audit in accordance with the nursing home’s Medicaid provider enrollment agreements.

The bill limits the civil penalty to half the total dollar amount of the rate increase the nursing home received but did not use to enhance employee wages.

It authorizes DSS, in the department’s sole discretion, to enter a recoupment schedule with a nursing home so as not to negatively impact patient care.

Nursing homes subject to a civil penalty may request a rehearing under provisions in existing law (see BACKGROUND).

DSS’s authorization to assess civil penalties under the bill applies to rate increases nursing homes receive before the bill’s effective date under last year’s budget (PA 21-2, June Special Session, § 323).

That act required DSS to increase nursing home rates by 4.5% in both FY 22 and FY 23 to enhance wages for employees.

Under the act, facilities that received a rate adjustment for wage enhancements but failed to provide them may be subject to a rate decrease in the same amount.

EFFECTIVE DATE:

Upon passage BACKGROUND SB281 / File No.

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151 Rehearing a Rate Decision State law allows nursing homes aggrieved by a DSS decision to apply for a rehearing within 10 days after the written notice of DSS’s decision.

Nursing homes must file a detailed written description of all items of aggrievement with DSS within 90 days after the written notice.

DSS must issue a final decision within 60 days after the close of evidence or the date on which final briefs are filed, whichever is later.

Items not resolved at the rehearing are submitted to binding arbitration (CGS § 17b-238(b)).