Connecticut 2021 Regular Session Status: In Committee

HB 6446 — AN ACT CONCERNING THE GOVERNOR'S BUDGET RECOMMENDATIONS FOR HUMAN SERVICES.

Last action — REF. BY HOUSE TO COMMITTEE ON Appropriations

  1. ✓
    Introduced
  2. 2
    In Committee
  3. 3
    Passed House
  4. 4
    Passed Senate
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 2021 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Bill Text

What changed in the latest version

1752 added · 1819 removed

1752 line(s) added, 1819 removed.

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General Assembly Governor's Bill No.
House of Representatives General Assembly File No.
6446 January Session, 2021 LCO No.
263 January Session, 2021 Substitute House Bill No.
3112 Referred to Committee on HUMAN SERVICES Introduced by:
6446 House of Representatives, April 6, 2021 The Committee on Human Services reported through REP.
Request of the Governor Pursuant to Joint Rule 9 AN ACT CONCERNING THE GOVERNOR'S BUDGET RECOMMENDATIONS FOR HUMAN SERVICES.
ABERCROMBIE of the 83rd Dist., Chairperson of the Committee on the part of the House, that the substitute bill ought to pass.
AN ACT CONCERNING THE GOVERNOR'S BUDGET RECOMMENDATIONS FOR HUMAN SERVICES.
Subsection (b) of section 17b-104 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2021):
(b) On July 1, 2007, and annually thereafter, the commissioner shall increase the payment standards over those of the previous fiscal year under the temporary family assistance program and the state- administered general assistance program by the percentage increase, if any, in the most recent calendar year average in the consumer price index for urban consumers over the average for the previous calendar year, provided the annual increase, if any, shall not exceed five per cent, except that the payment standards for the fiscal years ending June 30, 2010, June 30, 2011, June 30, 2012, June 30, 2013, June 30, 2016, June 30, 2017, June 30, 2018, June 30, 2019, June 30, 2020, [and] June 30, 2021, June 30, 2022, and June 30, 2023, shall not be increased.
LCO No.
3112 1 of 51 Governor's Bill No.6446 Sec.
2.
Subsection (a) of section 17b-106 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2021):
(a) On July 1, 1989, and annually thereafter, the commissioner shall increase the adult payment standards over those of the previous fiscal year for the state supplement to the federal Supplemental Security Income Program by the percentage increase, if any, in the most recent calendar year average in the consumer price index for urban consumers over the average for the previous calendar year, provided the annual increase, if any, shall not exceed five per cent, except that the adult payment standards for the fiscal years ending June 30, 1993, June 30, 1994, June 30, 1995, June 30, 1996, June 30, 1997, June 30, 1998, June 30, 1999, June 30, 2000, June 30, 2001, June 30, 2002, June 30, 2003, June 30, 2004, June 30, 2005, June 30, 2006, June 30, 2007, June 30, 2008, June 30, 2009, June 30, 2010, June 30, 2011, June 30, 2012, June 30, 2013, June 30, 2016, June 30, 2017, June 30, 2018, June 30, 2019, June 30, 2020, [and] June 30, 2021, June 30, 2022, and June 30, 2023, shall not be increased.
Effective October 1, 1991, the coverage of excess utility costs for recipients of the state supplement to the federal Supplemental Security Income Program is eliminated.
Notwithstanding the provisions of this section, the commissioner may increase the personal needs allowance component of the adult payment standard as necessary to meet federal maintenance of effort requirements.
Sec.
3.
Section 17b-256f of the general statutes is repealed and the following is substituted in lieu thereof (Effective August 1, 2022):
TheCommissionerofSocialServicesshallincreaseincomedisregards used to determine eligibility by theDepartment ofSocialServicesfor the federal Qualified Medicare Beneficiary, the Specified Low-Income Medicare Beneficiary and the Qualifying Individual programs, administered in accordance with the provisions of 42 USC 1396d(p), by such amounts that shall result in persons with income that is (1) less than two hundred eleven per cent of the federal poverty levelqualifying for the Qualified Medicare Beneficiary program, (2) at or above two LCO No.
3112 2 of 51 Governor's Bill No.6446 hundred eleven per cent of the federal poverty level but less than two hundred thirty-one per cent of the federal poverty level qualifying for the Specified Low-Income Medicare Beneficiary program, and (3) at or above two hundred thirty-one per cent of the federal poverty level but less than two hundred forty-six per cent of the federal poverty level qualifying for the Qualifying Individual program.
The commissioner shall [not] apply an asset test for eligibility under the Medicare Savings Program.
Eligible persons shall have countable assets less than or equal to two times the amount of allowable assets for Medicare Savings Programs as identified by the Centers for Medicare and Medicaid Services.
The commissioner shall not consider as income Aid and Attendance pension benefits granted to a veteran, as defined in section 27-103, or the surviving spouse of such veteran.
The Commissioner of Social Services, pursuant to section 17b-10, may implement policies and procedures to administer the provisions of this section while in the process of adopting such policies and procedures in regulation form, provided the commissioner prints notice of the intent to adopt the regulations on the department's Internet web site and the eRegulations System not later than twenty days after the date of implementation.
Such policies and procedures shall be valid until the time final regulations are adopted.
Sec.
4.
(a) In accordance with 42 USC 1396k, the Department of Social Services shall be subrogated to any right of recovery or indemnification that an applicant or recipient of medical assistance or any legally liable relative of such applicant or recipient has against an insurer or other legally liable third party including, but not limited to, a self-insured plan, group health plan, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974, service benefit plan, managed care organization, health care center, pharmacy benefit manager, dental benefit manager, third-party administrator or other party that is, by statute, contract or agreement, legally responsible for payment of a claim for a health care item or service, for the cost of all health care items LCO No.
(a) In accordance with 42 USC 1396k, the Department of Social Services shall be subrogated to any right of recovery or indemnification that an applicant or recipient of medical assistance or any legally liable relative of such applicant or recipient has against an insurer or other legally liable third party including, but not limited to, a self-insured plan, group health plan, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974, service benefit plan, managed care organization, health care center, pharmacy benefit manager, dental benefit manager, third-party administrator or other party that is, by statute, contract or agreement, legally responsible for payment of a claim for a health care item or service, for the cost of all health care items sHB6446 / File No.
3112 3 of 51 Governor's Bill No6446 or services furnished to the applicant or recipient, including, but not limited to, hospitalization, pharmaceutical services, physician services, nursing services, behavioral health services, long-term care services and other medical services, not to exceed the amount expended by the department for such care and treatment of the applicant or recipient.
263 1 sHB6446 File No.
263 or services furnished to the applicant or recipient, including, but not limited to, hospitalization, pharmaceutical services, physician services, nursing services, behavioral health services, long-term care services and other medical services, not to exceed the amount expended by the department for such care and treatment of the applicant or recipient.
In accordance with subsection (b) of section 38a-472, a provider that has received an assignment from the department shall notify the recipient's health insurer or other legally liable third party including, but not limited to, a self-insured plan, group health plan, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974, service benefit plan, managed care organization, health care center, pharmacy benefit manager, dental benefit manager, third-party administrator or other party that is, by statute, contract or agreement, legally responsible for LCO No.
In accordance with subsection (b) of section 38a-472, a provider that has received an assignment from the department shall notify the recipient's health insurer or other legally liable third party including, but not limited to, a self-insured plan, group health plan, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974, service benefit plan, managed care organization, health care center, pharmacy benefit manager, dental benefit manager, third-party administrator or other party that is, by statute, contract or agreement, legally responsible for payment of a claim for a health care item or service, of the assignment sHB6446 / File No.
3112 4 of 51 Governor's Bill No6446 payment of a claim for a health care item or service, of the assignment upon rendition of services to the applicant or recipient.
263 2 sHB6446 File No.
263 upon rendition of services to the applicant or recipient.
(e) No self-insured plan, group health plan, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974, service benefit plan, managed care plan, or any plan offered or administered by a health care center, pharmacy benefit manager,dental benefit manager, third-party administrator or other party that is, by statute, contract or LCO No.
(e) No self-insured plan, group health plan, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974, service benefit plan, managed care plan, or any plan offered or administered by a health care center, pharmacy benefit manager,dental benefit manager, third-party administrator or other party that is, by statute, contract or agreement, legally responsible for payment of a claim for a health care sHB6446 / File No.
3112 5 of 51 Governor's Bill No6446 agreement, legally responsible for payment of a claim for a health care itemor service, shall containany provisionthat hastheeffect of denying or limiting enrollment benefits or excluding coverage because services are rendered to an insured or beneficiary who is eligible for or who received medical assistance under this chapter.
263 3 sHB6446 File No.
263 itemor service, shall containany provisionthat hastheeffect of denying or limiting enrollment benefits or excluding coverage because services are rendered to an insured or beneficiary who is eligible for or who received medical assistance under this chapter.
(g) An insurer or other legally liable third party, upon receipt of a claim submitted by the department or the department's designee, in accordance with the requirements of subsection (c) of this section, for payment of a health care item or service covered under a state medical assistance program administered by the department, shall, not later than ninety days after receipt of the claim, or not later than ninety days after the effective date of this section, whichever is later, (1) make payment on the claim, (2) request information necessary to determine its legal obligation to pay the claim, or (3) issue a written reason for denial of the claim.
(g) An insurer or other legally liable third party, upon receipt of a claim submitted by the department or the department's designee, in accordance with the requirements of subsection (c) of this section, for payment of a health care item or service covered under a state medical assistance program administered by the department, shall, not later than ninety days after receipt of the claim or not later than ninety days after the effective date of this section, whichever is later, (1) make payment on the claim, (2) request information necessary to determine its legal obligation to pay the claim, or (3) issue a written reason for denial of the claim.
(h) On and after July 1, 2021, an insurer or other legally liable third party who has reimbursed the department for a health care item or LCO No.
(h) On and after July 1, 2021, an insurer or other legally liable third party who has reimbursed the department for a health care item or service paid for and covered under a state medical assistance program sHB6446 / File No.
3112 6 of 51 Governor's Bill No6446 service paid for and covered under a state medical assistance program administered by the department, shall, upon determining it is not liable and at risk for cost of the health care item or service, request any refund from the department not later than twelve months from the date of its reimbursement to the department.
263 4 sHB6446 File No.
263 administered by the department shall, upon determining it is not liable and at risk for cost of the health care item or service, request any refund from the department not later than twelve months from the date of its reimbursement to the department.
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Section 17b-244 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2021):
Section 17b-340d of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):
(a) The room and board component of the rates to be paid by the state to private facilities and facilities operated by regional education service centers which are licensed to provide residential care pursuant to section 17a-227, but not certified to participate in the Title XIX Medicaid program as intermediate care facilities for individuals with intellectual disabilities, shall be determined annually by the Commissioner of Social Services, except that rates effective April 30, 1989, shall remain in effect through October 31, 1989.
Any facility with real property other than land placed in service prior to July 1, 1991, shall, for the fiscal year ending June 30, 1995, receive a rate of return on real property equal to theaverageoftheratesofreturnappliedtorealpropertyotherthanland placed in service for the five years preceding July 1, 1993.
For the fiscal year ending June 30, 1996, and any succeeding fiscal year, the rate of return on real property for property items shall be revised every five years.
The commissioner shall, upon submission of a request by such facility, allow actual debt service, comprised of principal and interest, on the loan or loans in lieu of property costs allowed pursuant to section 17-313b-5 of the regulations of Connecticut state agencies, whether actual debt service is higher or lower than such allowed property costs, provided such debt service terms and amounts are reasonable in relation to the useful life and the base value of the property.
In the case of facilities financed through the Connecticut Housing Finance Authority, the commissioner shall allow actual debt service, comprised of principal, interest and a reasonable repair and replacement reserve on the loan or loans in lieu of property costs allowed pursuant to section 17-313b-5 of the regulations of Connecticut state agencies, whether actual debt service is higher or lower than such allowed property costs, LCO No.
3112 7 of 51 Governor's Bill No6446 provided such debt service terms and amounts are determined by the commissioner at the time the loan is entered into to be reasonable in relation to the useful life and base value of the property.
The commissioner may allow fees associated with mortgage refinancing provided such refinancing will result in state reimbursement savings, after comparing costs over the terms of the existing proposed loans.
For the fiscal year ending June 30, 1992, the inflation factor used to determine rates shall be one-half of the gross national product percentage increase for the period between the midpoint of the cost year through the midpoint of the rate year.
For fiscal year ending June 30, 1993, the inflation factor used to determine rates shall be two-thirds of the gross national product percentage increase from the midpoint of the cost year to the midpoint of the rate year.
For the fiscal years ending June 30, 1996, and June 30, 1997, no inflation factor shall be applied in determining rates.
The Commissioner of Social Services shall prescribe uniformformsonwhichsuchfacilitiesshallreporttheircosts.Suchrates shall be determined on the basis of a reasonable payment for necessary services.
Any increase in grants, gifts, fund-raising or endowment income used for the payment of operating costs by a private facility in the fiscal year ending June 30, 1992, shall be excluded by the commissioner from the income of the facility in determining the rates to be paid to the facility for the fiscal year ending June 30, 1993, provided any operating costs funded by such increase shall not obligate the state to increase expenditures in subsequent fiscal years.
Nothing contained in this section shall authorize a payment by the state to any such facility in excess of the charges made by the facility for comparable services to the general public.
The service component of the rates to be paid by the state to private facilities and facilities operated by regional education service centers which are licensed to provide residential care pursuant to section 17a-227, but not certified to participate in the Title XIX Medicaid programs as intermediate care facilities for individuals with intellectual disabilities, shall be determined annually by the Commissioner of Developmental Services in accordance with section 17b-244a.ForthefiscalyearendingJune30,2008,nofacilityshallreceive a rate that is more than two per cent greater than the rate in effect for LCO No.
3112 8 of 51 Governor's Bill No6446 the facility on June 30, 2007, except any facility that would have been issued a lower rate effective July 1, 2007, due to interim rate status or agreement withthedepartment,shallbeissuedsuchlower rate effective July 1, 2007.
For the fiscal year ending June 30, 2009, no facility shall receive arate that ismore thantwo per centgreaterthantherateineffect for the facility on June 30, 2008, except any facility that would have been issued a lower rate effective July 1, 2008, due to interim rate status or agreement withthedepartment,shallbeissuedsuchlower rate effective July 1, 2008.
For the fiscal years ending June 30, 2010, and June 30, 2011, rates in effect for the period ending June 30, 2009, shall remain in effect untilJune30,2011,exceptthat(1)theratepaidtoafacilitymaybehigher than the rate paid to the facility for the period ending June 30, 2009, if a capital improvement required by the Commissioner of Developmental Services for the health or safety of the residents was made to the facility during the fiscal yearsending June 30, 2010, or June 30, 2011, and (2) any facility that would have been issued a lower rate for the fiscal year ending June 30, 2010, or June 30, 2011, due to interim rate status or agreement with the department, shall be issued such lower rate.
For the fiscalyear ending June 30,2012,ratesineffect for theperiodending June 30, 2011, shall remain in effect until June 30, 2012, except that (A) the rate paid to a facility may be higher than the rate paid to the facility for the period ending June 30, 2011, if a capital improvement required by the Commissioner of Developmental Services for the health or safety of the residents was made to the facility during the fiscal year ending June 30, 2012, and (B) any facility that would have been issued a lower rate for the fiscal year ending June 30, 2012, due to interim rate status or agreement with the department, shall be issued such lower rate.
Any facility that has a significant decrease in land and building costs shall receiveareducedratetoreflectsuchdecreaseinlandandbuilding costs.
The rate paid to a facility may be increased if a capital improvement approvedbytheDepartmentofDevelopmentalServices,inconsultation with the Department of Social Services, for the health or safety of the residents was made to the facility during the fiscal year ending June 30, 2014, or June 30, 2015, only to the extent such increases are within available appropriations.
For the fiscal years ending June 30, 2016, and LCO No.
3112 9 of 51 Governor's Bill No6446 June 30, 2017, rates shall not exceed those in effect for the period ending June 30, 2015, except the rate paid to a facility may be higher than the rate paid to the facility for the period ending June 30, 2015, if a capital improvement approved by the Department of Developmental Services, in consultation with the Department of Social Services, for the health or safety of the residents was made to the facility during the fiscal year ending June 30, 2016, or June 30, 2017, to the extent such rate increases are within available appropriations.
For the fiscal years ending June 30, 2016, and June 30, 2017, and each succeeding fiscal year, any facility that wouldhave beenissuedalowerrate,due tointerimrate status,achange in allowable fair rent or agreement with the department, shall be issued such lower rate.
For the fiscal years ending June 30, 2018, and June 30, 2019, rates shall not exceed those in effect for the period ending June 30, 2017, except the rate paid to a facility may be higher than the rate paid to the facility for the period ending June 30, 2017, if a capital improvement approved by the Department of Developmental Services, in consultation with the Department of Social Services, for the health or safety of the residents was made to the facility during the fiscal year ending June 30, 2018, or June 30, 2019, to the extent such rate increases are within available appropriations.
For the fiscal years ending June 30, 2020, andJune30, 2021, ratesshallnot exceed thoseineffect for thefiscal year ending June30, 2019,except therate paidto afacility may behigher than the rate paid to the facility for the fiscal year ending June 30, 2019, if a capital improvement approved by the Department of Developmental Services, in consultation with the Department of Social Services, for the health or safety of the residents was made to the facility during thefiscalyear ending June 30, 2020, or June30, 2021,to theextent such rate increases are within available appropriations.
For the fiscal years ending June 30, 2022, and June 30, 2023, rates shall not exceed those in effect for the fiscal year ending June 30, 2021, except the rate paid to a facility may be higher than the rate paid to the facility for the fiscal year ending June 30, 2021, if a capital improvement approved by the Department of Developmental Services, in consultation with the Department of Social Services, for the health or safety of the residents was made to the facility during the fiscal year ending June 30, 2022, or LCO No.
3112 10 of 51 Governor's Bill No6446 June 30, 2023, to the extent such rate increases are within available appropriations.
(b) Notwithstanding the provisions of subsection (a) of this section, state rates of payment for the fiscal years ending June 30, 2018, June 30, 2019, June 30, 2020, [and] June 30, 2021, June 30, 2022, and June 30, 2023, for residential care homes and community living arrangements that receive theflatrate forresidentialservicesunder section17-311-54ofthe regulations of Connecticut state agencies shall be set in accordance with section [298 of public act 19-117] 6 of this act.
(c) The Commissioner of Social Services and the Commissioner of Developmental Services shall adopt regulations in accordance with the provisions of chapter 54 to implement the provisions of this section.
Sec.6.(EffectiveJuly1,2021)Notwithstandingsubsection(a)ofsection 17b-244 of the general statutes, as amended by this act, and subsections (a) to (i), inclusive, of section 17b-340 of the general statutes or any other provision of the general statutes, or regulation adopted thereunder, the state rates of payments in effect for the fiscal year ending June 30, 2016, for residential care homes, community living arrangements and community companion homes that receive the flat rate for residential services under section 17-311-54 of the regulations of Connecticut state agencies shall remain in effect until June 30, 2023.
Sec.
7.
Section 17b-340d of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2021):
[In the course of developing such a system, the commissioner shall review the skilled nursing facility prospective payment system developed by the Centers for Medicare and Medicaid Services, as well as other methodologies used nationally, and shall consider recommendations from the nursing home industry.] Notwithstanding section 17b-340, as amended by this act, for the fiscal year ending June 30, 2022, and annually thereafter, the Commissioner of LCO No.
[In the course of developing such a system, the commissioner shall review the skilled nursing facility prospective payment system developed by the Centers for Medicare and Medicaid Services, as well as other methodologies used nationally, and shall consider recommendations from the nursing home industry.] Notwithstanding the provisions of section 17b-340, as amended by this act, beginning on October 1, 2021, and ending on June 30, 2022, and each fiscal year ending on June thirtieth thereafter, the Commissioner of Social Services shall establish Medicaid rates paid to nursing home facilities based on cost years ending on September thirtieth in accordance with the following:
3112 11 of 51 Governor's Bill No6446 Social Services shall establish Medicaid rates paid to nursing home facilities based on cost years ending on September thirtieth in accordance with the following:
(1) Case-mix adjustments to the direct care component shall be made or phased in effective October 1, 2021, and updated every quarter thereafter.
(1) Case-mix adjustments to the direct care component shall be made or phased in effective beginning July 1, 2021, and updated every quarter thereafter.
(C) fair rent, which shall be defined in regulations adopted in accordance with subsection (b) of this section;
(C) sHB6446 / File No.
263 5 sHB6446 File No.
263 fair rent, which shall be defined in regulations adopted in accordance with subsection (b) of this section;
(ii)indirect costs,themaximum cost shallbeequaltoone hundred fifteen per cent of the state-wide median allowable cost;
(ii)indirect costs,themaximumcost shallbeequaltoone hundred fifteen per cent of the state-wide median allowable cost;
(4) For the fiscal year ending June 30, 2022, the commissioner may, in the commissioner's discretion and within available appropriations, LCO No.
(4) For the period beginning on October 1, 2021, and ending on June 30, 2022, the commissioner may, in the commissioner's discretion and within available appropriations, provide pro rata fair rent increases to facilities which have documented fair rent additions placed in service in thecostreportyearendingonSeptember30, 2019,thatarenot otherwise included in the rates issued.
3112 12 of 51 Governor's Bill No6446 provide pro rata fair rent increases to facilities which have documented fair rent additions placed in service in the cost report year ending September 30, 2019, that are not otherwise included in the rates issued.
(5) There shall be no increase to rates based on inflation or any inflationary factor for the period beginning on October 1, 2021, and ending on June 30, 2023.
(5) There shall be no increase to rates based on inflation or any inflationary factor for the fiscal years ending June 30, 2022, and June 30, 2023.
(b) The Commissioner of Social Services may implement policies as necessary to carry out the provisions of this section while in the process of adopting the policies as regulations, provided that prior to implementation the policies are posted (1) on the eRegulations System established pursuant to section 4-173b and (2) the Department of Social Services' Internet web site.
(b) The Commissioner of Social Services may implement policies as sHB6446 / File No.
263 6 sHB6446 File No.
263 necessary to carry out the provisions of this section while in the process of adopting the policies as regulations, provided that prior to implementation the policies are posted (1) on the eRegulations System established pursuant to section 4-173b and (2) the Department of Social Services' Internet web site.
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3.
and (4) "profit and loss statement" means the most recent annual statement on profits and losses finalized by a related LCO No.
and (4) "profit and loss statement" means the most recent annual statement on profits and losses finalized by a related party before the annual report mandated under this subsection.
3112 13 of 51 Governor's Bill No6446 party before the annual report mandated under this subsection.
Cost of such services shall include reasonable costs mandated by collective bargaining agreements with certified collective bargaining agents or other agreements between the employer and employees, provided "employees" shall not include persons employed asmanagersor chiefadministratorsorrequiredto belicensed as nursing home administrators, and compensation for services rendered by proprietors at prevailing wage rates, as determined by application of principles of accounting as prescribed by said commissioner.
Cost of such services shall include reasonable costs mandated by collective bargaining agreements with certified sHB6446 / File No.
263 7 sHB6446 File No.
263 collective bargaining agents or other agreements between the employer and employees, provided "employees" shall not include persons employed asmanagersor chiefadministratorsorrequiredto belicensed as nursing home administrators, and compensation for services rendered by proprietors at prevailing wage rates, as determined by application of principles of accounting as prescribed by said commissioner.
The commissionermay,inthecommissioner'sdiscretion,allowtheinclusion ofextraordinary andunanticipatedcostsofproviding services that were incurredtoavoidanimmediatenegativeimpactonthehealthandsafety LCO No.
The commissionermay,inthecommissioner'sdiscretion,allowtheinclusion ofextraordinary andunanticipatedcostsofproviding services that were incurredtoavoidanimmediatenegativeimpactonthehealthandsafety of patients.
3112 14 of 51 Governor's Bill No6446 of patients.
Effective July 1, 1991, in facilities that have both a chronic and convalescent nursing home and a rest home with nursing supervision, theratefortherest home withnursing supervisionshallnot exceedsuch facility's rate for its chronic and convalescent nursing home.
Effective July 1, 1991, in facilities that have both a chronic and convalescent nursing home and a rest home with nursing supervision, theratefortherest home withnursing supervisionshallnot exceedsuch sHB6446 / File No.
263 8 sHB6446 File No.
263 facility's rate for its chronic and convalescent nursing home.
If a licensed residential care home fails to submit a complete and accurate report, the department shall notify such home of the failure and the home shall have thirty days from the LCO No.
If a licensed residential care home fails to submit a complete and accurate report, the department shall notify such home of the failure and the home shall have thirty days from the date the notice was issued to submit a complete and accurate report.
3112 15 of 51 Governor's Bill No6446 date the notice was issued to submit a complete and accurate report.
For the cost reporting year commencing October 1, 1985, and for subsequent cost reporting years, facilities shall report the cost of using the services of any nursing pool employee by separating said cost into two categories, the portion of the cost equal to the salary of the employee for whom the nursing pool employee is substituting shall be considered a nursing cost and any cost in excess of such salary shall be further divided so that seventy-five per cent of the excess cost shall be considered an administrative or general cost and twenty-five per cent oftheexcesscost shall be consideredanursing cost, provided if the total nursing pool costs of a facility for any cost year are equal to or exceed fifteen per cent of the total nursing expenditures of the facility for such cost year, no portion of nursing pool costs in excess of fifteen per cent shall be classified as administrative or general costs.
For the cost reporting year commencing October 1, 1985, and for subsequent cost reporting years, facilities shall report the cost of using the services of any nursing pool employee by separating said cost into two categories, the portion of the cost equal to the salary of the employee for whom the nursing pool employee is substituting shall be considered a nursing cost and any cost in excess of such salary shall be further divided so that seventy-five per cent of the excess cost shall be considered an administrative or general cost and twenty-five per cent oftheexcesscost shall be consideredanursing cost, provided if the total nursing pool costs of a facility for any cost year are sHB6446 / File No.
263 9 sHB6446 File No.
263 equal to or exceed fifteen per cent of the total nursing expenditures of the facility for such cost year, no portion of nursing pool costs in excess of fifteen per cent shall be classified as administrative or general costs.
If changes in federal or state laws, regulations or standards adopted subsequent to June 30, 1985, result in increased costs or expenditures in an amount exceeding one-half of one per cent of allowable costs for the most recent cost reporting year, the commissioner shall adjust rates and provide payment for any such LCO No.
If changes in federal or state laws, regulations or standards adopted subsequent to June 30, 1985, result in increased costs or expenditures in an amount exceeding one-half of one per cent of allowable costs for the most recent cost reporting year, the commissioner shall adjust rates and provide payment for any such increased reasonable costs or expenditures within a reasonable period of time retroactive to the date of enforcement.
3112 16 of 51 Governor's Bill No6446 increased reasonable costs or expenditures within a reasonable period of time retroactive to the date of enforcement.
The established rates shall be the maximum amount chargeable by such facilities for care of such beneficiaries, and the acceptance by or on behalf of any such facility of any additional compensation for care of any such beneficiary from any other person or source shall constitute the offense of aiding a beneficiary to obtain aid to which the beneficiary is not entitled and shall be punishable in the same manner as is provided in subsection (b) of section 17b-97.
The established rates shall be the maximum amount chargeable by such facilities for care of such beneficiaries, and the acceptance by or on behalf of any such facility of any additional compensation for care of any such beneficiary from any other person or source shall constitute the offense of aiding a beneficiary to obtain aid to which the beneficiary is not entitled and shall be punishable in the sHB6446 / File No.
263 10 sHB6446 File No.
263 same manner as is provided in subsection (b) of section 17b-97.
imposition of receivership pursuant LCO No.
imposition of receivership pursuant to sections 19a-542 and 19a-543;
3112 17 of 51 Governor's Bill No6446 to sections 19a-542 and 19a-543;
No interim rate shall be increased pursuant to this subsection in excess of one hundred fifteen per cent of the median rate for the facility's peer grouping, established pursuant to subdivision (2) of subsection (f) of this section, unless recommended by the commissioner and approved by the Secretary of the Office of Policy and Management after consultation with the commissioner.
No interim rate shall be increased pursuant to this subsection in excess of one hundred fifteen per cent of the median rate for the facility's peer grouping, established pursuant to subdivision (2) sHB6446 / File No.
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263 of subsection (f) of this section, unless recommended by the commissioner and approved by the Secretary of the Office of Policy and Management after consultation with the commissioner.
With the approval of the Secretary of the Office of Policy and Management, the commissioner may waive recovery and rescission of the interim rate for good cause shown that is not inconsistent with this section, including, but not limited to, transferstofamily membersthat were madefor novalue.The LCO No.
With the approval of the Secretary of the Office of Policy and Management, the commissioner may waive recovery and rescission of the interim rate for good cause shown that is not inconsistent with this section, including, but not limited to, transferstofamily membersthat were madefor novalue.The commissioner shall provide written quarterly reports to the joint standing committees of the General Assembly having cognizance of matters relating to aging, human services and appropriations and the budgets of state agencies, that identify each facility requesting an interim rate increase, the amount of the requested rate increase for each facility,theactiontakenbythecommissioner andthesecretarypursuant to this subsection, and estimates of the additional cost to the state for each approved interim rate increase.
3112 18 of 51 Governor's Bill No6446 commissioner shall provide written quarterly reports to the joint standing committees of the General Assembly having cognizance of matters relating to aging, human services and appropriations and the budgets of state agencies, that identify each facility requesting an interim rate increase, the amount of the requested rate increase for each facility,theactiontakenbythecommissioner andthesecretarypursuant to this subsection, and estimates of the additional cost to the state for each approved interim rate increase.
For purposes of this section, other allowable services means those services required by any medical assistance beneficiary residing in such home or hospital which are not already covered in the rate set by the commissioner in accordance with the provisions of subsection (a) of this section] The Commissioner of Social Services may implement policies and procedures as necessary to carry out the provisions of this section while in the process of adopting the policies and procedures as regulations, provided notice of intent to adopt the regulations is published in accordance with the provisions of section 17b-10 not later than twenty days after the date of implementation.
For purposes of this section, other allowable services means sHB6446 / File No.
263 12 sHB6446 File No.
263 those services required by any medical assistance beneficiary residing in such home or hospital which are not already covered in the rate set by the commissioner in accordance with the provisions of subsection (a) of this section] The Commissioner of Social Services may implement policies and procedures as necessary to carry out the provisions of this section while in the process of adopting the policies and procedures as regulations, provided notice of intent to adopt the regulations is published in accordance with the provisions of section 17b-10 not later than twenty days after the date of implementation.
No facility shall accept payment in excess of the reasonable and necessary costs of other allowable services as specified by the commissioner pursuant to the regulations adopted under subsection (b) of this section for any public assistance patient from this LCO No.
No facility shall accept payment in excess of the reasonable and necessary costs of other allowable services as specified by the commissioner pursuant to the regulations adopted under subsection (b) of this section for any public assistance patient from this or any other state.
3112 19 of 51 Governor's Bill No6446 or any other state.
(e) Except as provided in this subsection, the provisions of subsections (c) and (d) of this section shall not apply to any facility subject to the requirements of this section, which on October 1, 1981, (1) was accepting payments from the commissioner in accordance with the provisions of subsection (a) of this section, (2) was accepting medical assistance payments from another state for at least twenty per cent of its patients, and (3) had not notified the commissioner of any intent to terminate its provider agreement, in accordance with section 17b-271, provided no patient residing in any such facility on May 22, 1984, shall be removed from such facility for purposes of meeting the requirements of this subsection.
(e) Except as provided in this subsection, the provisions of subsections (c) and (d) of this section shall not apply to any facility subject to the requirements of this section, which on October 1, 1981, (1) was accepting payments from the commissioner in accordance with the sHB6446 / File No.
263 13 sHB6446 File No.
263 provisions of subsection (a) of this section, (2) was accepting medical assistance payments from another state for at least twenty per cent of its patients, and (3) had not notified the commissioner of any intent to terminate its provider agreement, in accordance with section 17b-271, provided no patient residing in any such facility on May 22, 1984, shall be removed from such facility for purposes of meeting the requirements of this subsection.
(f) For the fiscal years ending on or before June 30, 2021, rates for nursing home facilities shall be set in accordance with this subsection.
(f) For the fiscal years ending on or before June 30, 2021, and for the period beginning on July 1, 2021, and ending on September 30, 2021, rates for nursing home facilities shall be set in accordance with this subsection.
On and after July 1, 2021, such rates shall be set in accordance with section 17b-340d, as amended by this act.
On and after October 1, 2021, such rates shall be set in accordance with section 17b-340d, as amended by this act.
For the fiscal year ending June 30, 1992, the rates paid by or for persons aided or cared for by the state LCO No.
For the fiscal year ending June30, 1992,theratespaidby orfor personsaidedor cared for by the state or any town in this state to facilities for room, board and services specified in licensing regulations issued by the licensing agency, except intermediate care facilities for individuals with intellectual disabilities and residential care homes, shall be based on the cost year ending September 30, 1989.
3112 20 of 51 Governor's Bill No6446 or any town in this state to facilities for room, board and services specified in licensing regulations issued by the licensing agency, except intermediate care facilities for individuals with intellectual disabilities and residential care homes, shall be based on the cost year ending September 30, 1989.
(C) fair rent, which shall be defined in accordance with subsection (f) of section 17-311-52 of the regulations of Connecticut state agencies;
(C) fair rent, which shall be defined in accordance with subsection (f) of sHB6446 / File No.
263 14 sHB6446 File No.
263 section 17-311-52 of the regulations of Connecticut state agencies;
The other peer grouping shall be comprised LCO No.
The other peer grouping shall be comprised of facilities located in all other counties.
3112 21 of 51 Governor's Bill No6446 of facilities located in all other counties.
for fair rent, the amount shall be calculated utilizing the amount approved by the Office of Health Care Access pursuant to section 19a-638;
for fair rent, the amount shall sHB6446 / File No.
263 15 sHB6446 File No.
263 be calculated utilizing the amount approved by the Office of Health Care Access pursuant to section 19a-638;
For direct costs, the maximum shall be equal to one LCO No.
For direct costs, the maximum shall be equal to one hundred thirty-five per cent of the median allowable cost of that peer grouping;
3112 22 of 51 Governor's Bill No6446 hundred thirty-five per cent of the median allowable cost of that peer grouping;
for indirect costs,themaximumshallbeequalto onehundred twenty per cent of the state-wide median allowable cost;
for indirect costs,themaximum shallbeequalto onehundred twenty per cent of the state-wide median allowable cost;
and for administrative and general costs the maximum shall be equal to the state-wide median allowable cost.
and for administrative and general costs the sHB6446 / File No.
263 16 sHB6446 File No.
263 maximum shall be equal to the state-wide median allowable cost.
Costs in excess of the maximum amounts established under this subsection shall not be recognized as allowable costs, except that the Commissioner of Social Services (A) may allow costs in excess of maximum amounts for any facility with patient days covered by LCO No.
Costs in excess of the maximum amounts established under this subsection shall not be recognized as allowable costs, except that the Commissioner of Social Services (A) may allow costs in excess of maximum amounts for any facility with patient days covered by Medicare, including days requiring coinsurance, in excess of twelve per cent of annual patient days which also has patient days covered by Medicaid in excess of fifty per cent of annual patient days;
3112 23 of 51 Governor's Bill No6446 Medicare, including days requiring coinsurance, in excess of twelve per cent of annual patient days which also has patient days covered by Medicaid in excess of fifty per cent of annual patient days;
(4)For thefiscalyear ending June30,1992, (A)no facility shallreceive a rate that is less than the rate it received for the rate year ending June 30, 1991;
(4)For thefiscal year ending June30,1992, (A)no facility shallreceive a rate that is less than the rate it received for the rate year ending June 30, 1991;
and (C) no facility whose rate, if determinedpursuanttothissubsection,wouldbelessthanonehundred twenty per cent of the state-wide median rate, as determined pursuant to this subsection, shall receive a rate which is six and one-half per cent more than the rate it received for the rate year ending June 30, 1991.
and (C) no facility whose rate, if determinedpursuanttothissubsection,wouldbelessthanonehundred sHB6446 / File No.
263 17 sHB6446 File No.
263 twenty per cent of the state-wide median rate, as determined pursuant to this subsection, shall receive a rate which is six and one-half per cent more than the rate it received for the rate year ending June 30, 1991.
For the fiscal years ending June 30, 1996, and June 30, 1997, no facility shall receive a rate that is more than three per cent more than the rate it received for thepriorrateyear.ForthefiscalyearendingJune30,1998,afacilityshall LCO No.
For the fiscal years ending June 30, 1996, and June 30, 1997, no facility shall receive a rate that is more than three per cent more than the rate it received for thepriorrateyear.ForthefiscalyearendingJune30,1998,afacilityshall receive a rate increase that is not more than two per cent more than the rate that the facility received in the prior year.
3112 24 of 51 Governor's Bill No6446 receive a rate increase that is not more than two per cent more than the rate that the facility received in the prior year.
For the fiscal year ending June 30, 2000, no facility with an interim rate, replaced interim rate or scheduled rate adjustment specified in a certificate of need or other agreement for the fiscal year ending June 30, 2000, shall receive a rate increasethat ismore thanonepercent more thantheratethefacility receivedinthefiscalyearendingJune30,1999.Forthefiscalyearending June 30, 2001, each facility, except a facility with an interim rate or replaced interim rate for the fiscal year ending June 30, 2000, and a facility having a certificate of need or other agreement specifying rate adjustments for the fiscal year ending June 30, 2001, shall receive a rate increase equal to two per cent applied to the rate the facility received for the fiscal year ending June 30, 2000, subject to verification of wage enhancement adjustments pursuant to subdivision (14) of this subsection.
For the fiscal year ending June 30, 2000, no facility with an interim rate, replaced interim rate or scheduled rate adjustment specified in a certificate of need or other agreement for the fiscal year ending June 30, 2000, shall receive a rate increasethat ismore thanonepercent more thantheratethefacility sHB6446 / File No.
263 18 sHB6446 File No.
263 receivedinthefiscalyearendingJune30,1999.Forthefiscalyearending June 30, 2001, each facility, except a facility with an interim rate or replaced interim rate for the fiscal year ending June 30, 2000, and a facility having a certificate of need or other agreement specifying rate adjustments for the fiscal year ending June 30, 2001, shall receive a rate increase equal to two per cent applied to the rate the facility received for the fiscal year ending June 30, 2000, subject to verification of wage enhancement adjustments pursuant to subdivision (14) of this subsection.
For the fiscal year ending June LCO No.
For the fiscal year ending June 30, 2003, each facility shall receive a rate that is two per cent more than the rate the facility received in the prior fiscal year, except that such increase shall be effective January 1, 2003, and such facility rate in effect for the fiscal year ending June 30, 2002, shall be paid for services provided until December 31, 2002, except any facility that would have been issued a lower rate effective July 1, 2002, than for the fiscal year ending June 30, 2002, due to interim rate status or agreement with the department shall be issued such lower rate effective July 1, 2002, and havesuchrateincreasedtwopercenteffectiveJune1,2003.Forthefiscal year ending June 30, 2004, rates in effect for the period ending June 30, 2003, shall remain in effect, except any facility that would have been issued a lower rate effective July 1, 2003, than for the fiscal year ending June 30, 2003, due to interim rate status or agreement with the department shall be issued such lower rate effective July 1, 2003.
3112 25 of 51 Governor's Bill No6446 30, 2003, each facility shall receive a rate that is two per cent more than the rate the facility received in the prior fiscal year, except that such increase shall be effective January 1, 2003, and such facility rate in effect for the fiscal year ending June 30, 2002, shall be paid for services provided until December 31, 2002, except any facility that would have been issued a lower rate effective July 1, 2002, than for the fiscal year ending June 30, 2002, due to interim rate status or agreement with the department shall be issued such lower rate effective July 1, 2002, and havesuchrateincreasedtwopercenteffectiveJune1,2003.Forthefiscal year ending June 30, 2004, rates in effect for the period ending June 30, 2003, shall remain in effect, except any facility that would have been issued a lower rate effective July 1, 2003, than for the fiscal year ending June 30, 2003, due to interim rate status or agreement with the department shall be issued such lower rate effective July 1, 2003.
For the fiscalyear ending June 30,2005,ratesineffect for theperiodending June 30, 2004, shall remain in effect until December 31, 2004, except any facility that would have been issued a lower rate effective July 1, 2004, than for the fiscal year ending June 30, 2004, due to interim rate status or agreement with the department shall be issued such lower rate sHB6446 / File No.
For the fiscalyear ending June 30,2005,ratesineffect for theperiodending June 30, 2004, shall remain in effect until December 31, 2004, except any facility that would have been issued a lower rate effective July 1, 2004, than for the fiscal year ending June 30, 2004, due to interim rate status or agreement with the department shall be issued such lower rate effective July 1, 2004.
263 19 sHB6446 File No.
263 effective July 1, 2004.
For each facility not having an interim rate for the period ending June 30,2005,theratefortheperiodendingJune30,2006,shallbedetermined beginning with the higher of the computed rate based upon its 2003cost report filing ortherateineffect for theperiodending June30,2005.Such rate shall then be increased by eleven dollars and eighty cents per day LCO No.
For each facility not having an interim rate for the period ending June 30,2005,theratefortheperiodendingJune30,2006, shallbedetermined beginning with the higher of the computed rate based upon its 2003cost report filing ortherateineffect for theperiodending June30,2005.Such rate shall then be increased by eleven dollars and eighty cents per day except that in no event shall the rate for the period ending June 30, 2006, be thirty-two dollars more than the rate in effect for the period ending June 30, 2005, and for any facility with a rate below one hundred ninety- five dollars per day for the period ending June 30, 2005, such rate for the period ending June 30, 2006, shall not be greater than two hundred seventeen dollars and forty-three cents per day and for any facility with a rate equal to or greater than one hundred ninety-five dollars per day for the period ending June 30, 2005, such rate for the period ending June 30, 2006, shall not exceed the rate in effect for the period ending June 30, 2005, increased by eleven and one-half per cent.
3112 26 of 51 Governor's Bill No6446 except that in no event shall the rate for the period ending June 30, 2006, be thirty-two dollars more than the rate in effect for the period ending June 30, 2005, and for any facility with a rate below one hundred ninety- five dollars per day for the period ending June 30, 2005, such rate for the period ending June 30, 2006, shall not be greater than two hundred seventeen dollars and forty-three cents per day and for any facility with a rate equal to or greater than one hundred ninety-five dollars per day for the period ending June 30, 2005, such rate for the period ending June 30, 2006, shall not exceed the rate in effect for the period ending June 30, 2005, increased by eleven and one-half per cent.
For each facility with an interim rate for the period ending June 30, 2005, the interim replacement rate for the period ending June 30, 2006, shall not exceed the rate in effect for the period ending June 30, 2005, increased by eleven dollars and eighty cents per day plus the per day cost of the user fee payments made pursuant to section 17b-320 divided by annual resident service days, except for any facility with an interim rate below one hundred ninety-five dollars per day for the period ending June 30, 2005, the interim replacement rate for the period ending June 30, 2006, shall not be greater than two hundred seventeen dollars and forty-three cents sHB6446 / File No.
For each facility with an interim rate for the period ending June 30, 2005, the interim replacement rate for the period ending June 30, 2006, shall not exceed the rate in effect for the period ending June 30, 2005, increased by eleven dollars and eighty cents per day plus the per day cost of the user fee payments made pursuant to section 17b-320 divided by annual resident service days, except for any facility with an interim rate below one hundred ninety-five dollars per day for the period ending June 30, 2005, the interim replacement rate for the period ending June 30, 2006, shall not be greater than two hundred seventeen dollars and forty-three cents per day and for any facility with an interim rate equal to or greater than one hundred ninety-five dollars per day for the period ending June 30, 2005, the interim replacement rate for the period ending June 30, 2006, shall not exceed the rate in effect for the period ending June 30, 2005, increased by eleven and one-half per cent.
263 20 sHB6446 File No.
263 per day and for any facility with an interim rate equal to or greater than one hundred ninety-five dollars per day for the period ending June 30, 2005, the interim replacement rate for the period ending June 30, 2006, shall not exceed the rate in effect for the period ending June 30, 2005, increased by eleven and one-half per cent.
For the fiscal year ending June 30, 2007, each facility shall receive a rate that is three per cent greater than the rate in effect for the period ending June 30, 2006, except any facility that would have been issued a lower rate effective July 1, 2006, than for the rate period ending June 30, 2006, due to interim rate status or agreement with the department, shallbeissuedsuchlower rate effective July 1,2006.For the fiscal year ending June 30, 2008, each facility shall receive a rate that is two and nine-tenths per cent greater than the rate in effect for the period LCO No.
For the fiscal year ending June 30, 2007, each facility shall receive a rate that is three per cent greater than the rate in effect for the period ending June 30, 2006, except any facility that would have been issued a lower rate effective July 1, 2006, than for the rate period ending June 30, 2006, due to interim rate status or agreement with the department, shallbeissuedsuchlower rate effective July 1,2006.For the fiscal year ending June 30, 2008, each facility shall receive a rate that is two and nine-tenths per cent greater than the rate in effect for the period ending June 30, 2007, except any facility that would have been issued a lower rate effective July 1, 2007, than for the rate period ending June 30, 2007, due to interim rate status or agreement with the department, shall beissuedsuchlower rate effective July 1,2007.
3112 27 of 51 Governor's Bill No6446 ending June 30, 2007, except any facility that would have been issued a lower rate effective July 1, 2007, than for the rate period ending June 30, 2007, due to interim rate status or agreement with the department, shall beissuedsuchlower rate effective July 1,2007.
For the fiscal years ending June30, 2012, andJune30,2013,ratesineffect fortheperiodending June 30, 2011, shall remain in effect until June 30, 2013, except any facility that would have been issued a lower rate for the fiscal year ending June 30, 2012, or the fiscal year ending June 30, 2013, due to interim rate status or agreement with the department, shall be issued such lower rate.
For the fiscal years ending June30, 2012, andJune30, 2013,ratesineffect fortheperiodending June 30, 2011, shall remain in effect until June 30, 2013, except any facility that would have been issued a lower rate for the fiscal year ending June 30, 2012, or the fiscal year ending June 30, 2013, due to interim rate status or agreement with the department, shall be issued such lower rate.
For the fiscal year ending June 30, 2014, the department shall determine facility ratesbased upon2011cost report filingssubject to theprovisions of this section and applicable regulations except:
For sHB6446 / File No.
263 21 sHB6446 File No.
263 the fiscal year ending June 30, 2014, the department shall determine facility ratesbased upon2011cost report filingssubject to theprovisions of this section and applicable regulations except:
For the fiscal years ending June 30, 2016, and LCO No.
For the fiscal years ending June 30, 2016, and June 30, 2017, rates shall not exceed those in effect for the period ending June 30, 2015, except the rate paid to a facility may be higher than the rate paid to the facility for the period ending June 30, 2015, if the commissioner provides, within available appropriations, pro rata fair rentincreases,whichmay,atthediscretionofthecommissioner,include increases for facilities which have undergone a material change in circumstances related to fair rent additions or moveable equipment placed in service in cost report years ending September 30, 2014, and September 30, 2015, and not otherwise included in rates issued.
3112 28 of 51 Governor's Bill No6446 June 30, 2017, rates shall not exceed those in effect for the period ending June 30, 2015, except the rate paid to a facility may be higher than the rate paid to the facility for the period ending June 30, 2015, if the commissioner provides, within available appropriations, pro rata fair rentincreases,whichmay,atthediscretionofthecommissioner,include increases for facilities which have undergone a material change in circumstances related to fair rent additions or moveable equipment placed in service in cost report years ending September 30, 2014, and September 30, 2015, and not otherwise included in rates issued.
For the fiscal year ending June 30, 2018, the department shall determine facility rates based upon 2016 cost report filings subject to the provisions of this section and applicable regulations, provided no facility shall receive a rate that is higher than the rate in effect on December 31, 2016, and no facility shall receive a rate that is more than two per cent lower than the rate in effect on December 31, 2016.
For the fiscal year ending June 30, 2018, the department shall determine facility rates based upon 2016 cost report filings subject to the provisions of this section and applicable regulations, provided no facility shall receive a rate that is higher than the rate in effect on sHB6446 / File No.
263 22 sHB6446 File No.
263 December 31, 2016, and no facility shall receive a rate that is more than two per cent lower than the rate in effect on December 31, 2016.
For the fiscal year ending June 30, 2020, the department shall determine facility rates based upon 2018 cost report filings subject to the provisions of this section, adjusted to reflect any rate increases provided after the cost report year ending September 30, 2018, and applicable regulations, provided no facility shall receive a rate that is higher than LCO No.
For the fiscal year ending June 30, 2020, the department shall determine facility rates based upon 2018 cost report filings subject to the provisions of this section, adjusted to reflect any rate increases provided after the cost report year ending September 30, 2018, and applicable regulations, provided no facility shall receive a rate that is higher than the rate in effect on June 30, 2019, except the rate paid to a facility may be higher than the rate paid to the facility for the fiscal year ending June 30, 2019, if the commissioner provides, within available appropriations, pro rata fair rent increases, which may, at the discretion of the commissioner, include increases for facilities which have undergone a materialchangeincircumstancesrelatedtofairrentadditionsinthe cost report year ending September 30, 2018, and are not otherwise included in rates issued.
3112 29 of 51 Governor's Bill No.6446 the rate in effect on June 30, 2019, except the rate paid to a facility may be higher than the rate paid to the facility for the fiscal year ending June 30, 2019, if the commissioner provides, within available appropriations, pro rata fair rent increases, which may, at the discretion of the commissioner, include increases for facilities which have undergone a materialchangeincircumstancesrelatedto fairrentadditionsinthe cost report year ending September 30, 2018, and are not otherwise included in rates issued.
For the fiscal year ending June 30, 2021, no facility shall receive a rate that is higher than the rate in effect on June 30, 2020, except the rate paid to a facility may be higher than the rate paid to the facility for the fiscal year ending June 30, 2020, if the commissioner provides, within available appropriations, pro rata fair rentincreases,whichmay,atthediscretionofthecommissioner,include increases for facilities which have undergone a material change in circumstances related to fair rent additions in the cost report year ending September 30, 2019, and are not otherwise included in rates issued.
For the fiscal year ending June 30, 2021, no facility shall receive a rate that is higher than the rate in effect on June 30, 2020, except the rate paid to a facility may be higher than the rate paid to the facility for the fiscal year ending June 30, 2020, if the commissioner provides, within available appropriations, pro rata fair rentincreases,whichmay,atthediscretionofthecommissioner,include sHB6446 / File No.
263 23 sHB6446 File No.
263 increases for facilities which have undergone a material change in circumstances related to fair rent additions in the cost report year ending September 30, 2019, and are not otherwise included in rates issued.
For thefiscal years ending June 30, 2014, and June 30, 2015, the commissioner may, within LCO No.
For thefiscal years ending June 30, 2014, and June 30, 2015, the commissioner may, within availableappropriations,provideproratafairrentincreases,whichmay include moveable equipment at the discretion of the commissioner, for facilities which have undergone a material change in circumstances related to fair rent additions or moveable equipment placed in service in cost report years ending September 30, 2012, and September 30, 2013, and not otherwise included in rates issued.
3112 30 of 51 Governor's Bill No6446 availableappropriations,provideproratafairrentincreases,whichmay include moveable equipment at the discretion of the commissioner, for facilities which have undergone a material change in circumstances related to fair rent additions or moveable equipment placed in service in cost report years ending September 30, 2012, and September 30, 2013, and not otherwise included in rates issued.
Such adjustment shall provide a pro-rata increase based on direct and indirect care employee salaries reported in the 2014 annual cost report, and adjusted to reflect subsequent salary increases, to reflect reasonable costs mandated by collective bargaining agreements with certified collective bargaining agents, or otherwise provided by a facility to its employees.
Such adjustment shall provide a pro-rata increase based on direct and sHB6446 / File No.
263 24 sHB6446 File No.
263 indirect care employee salaries reported in the 2014 annual cost report, and adjusted to reflect subsequent salary increases, to reflect reasonable costs mandated by collective bargaining agreements with certified collective bargaining agents, or otherwise provided by a facility to its employees.
Facilities that receive such adjustment but do not provide increases in employee salaries as described in this subsection on or before July 31, 2015, may be subject to a rate decrease LCO No.
Facilities that receive such adjustment but do not provide increases in employee salaries as described in this subsection on or before July 31, 2015, may be subject to a rate decrease in the same amount as the adjustment by the commissioner.
3112 31 of 51 Governor's Bill No6446 in the same amount as the adjustment by the commissioner.
(5) For the purpose of determining allowable fair rent, a facility with allowable fair rent less than the twenty-fifth percentile of the state-wide allowable fair rent shall be reimbursed as having allowable fair rent equal to the twenty-fifth percentile of the state-wide allowable fair rent, provided for the fiscal years ending June 30, 1996, and June 30, 1997, the reimbursement may not exceed the twenty-fifth percentile of the state- wide allowable fair rent for the fiscal year ending June 30, 1995.
(5) For the purpose of determining allowable fair rent, a facility with allowable fair rent less than the twenty-fifth percentile of the state-wide allowable fair rent shall be reimbursed as having allowable fair rent equal to the twenty-fifth percentile of the state-wide allowable fair rent, sHB6446 / File No.
263 25 sHB6446 File No.
263 provided for the fiscal years ending June 30, 1996, and June 30, 1997, the reimbursement may not exceed the twenty-fifth percentile of the state- wide allowable fair rent for the fiscal year ending June 30, 1995.
The Commissioner of Social Services may revise the facility's fair rent component of its rate to reflect any financial LCO No.
The Commissioner of Social Services may revise the facility's fair rent component of its rate to reflect any financial benefitthefacilityoritsrelatedrealtyaffiliatereceivedasaresultofsuch financing or refinancing, including but not limited to, reductions in the amount of debt service payments or period of debt repayment.
3112 32 of 51 Governor's Bill No6446 benefitthefacilityoritsrelatedrealtyaffiliatereceivedasaresultofsuch financing or refinancing, including but not limited to, reductions in the amount of debt service payments or period of debt repayment.
The cost efficiency adjustments shall equal twenty-five per cent of the difference between allowable reported costs and the applicable median allowable cost established pursuant to this subdivision.
The cost efficiency adjustments shall equal twenty-five per cent of the difference between allowable reported costs sHB6446 / File No.
263 26 sHB6446 File No.
263 and the applicable median allowable cost established pursuant to this subdivision.
For the fiscal year ending June 30, 1996, LCO No.
For the fiscal year ending June 30, 1996, allowable operating costs, excluding fair rent, shall be inflated using the Regional Data Resources Incorporated McGraw-Hill Health Care Costs:
3112 33 of 51 Governor's Bill No6446 allowable operating costs, excluding fair rent, shall be inflated using the Regional Data Resources Incorporated McGraw-Hill Health Care Costs:
The commissioner shall determine whether and to what extent a change in ownership of a facility shall occasion the rebasing of the facility's costs.
The commissioner shall determine sHB6446 / File No.
(9) The method of establishing rates for new facilities shall be determined by the commissioner in accordance with the provisions of this subsection until June 30, 2021.
263 27 sHB6446 File No.
263 whether and to what extent a change in ownership of a facility shall occasion the rebasing of the facility's costs.
(9) The method of establishing rates for new facilities shall be determined by the commissioner in accordance with the provisions of this subsection until September 30, 2021.
(12) A chronic and convalescent nursing home having an ownership LCO No.
(12) A chronic and convalescent nursing home having an ownership affiliation with and operated at the same location as a chronic disease hospital may request that the commissioner approve an exception to applicable rate-setting provisions for chronic and convalescent nursing homes and establish a rate for the fiscal years ending June 30, 1992, and June 30, 1993, in accordance with regulations in effect June 30, 1991.
3112 34 of 51 Governor's Bill No6446 affiliation with and operated at the same location as a chronic disease hospital may request that the commissioner approve an exception to applicable rate-setting provisions for chronic and convalescent nursing homes and establish a rate for the fiscal years ending June 30, 1992, and June 30, 1993, in accordance with regulations in effect June 30, 1991.
(13)For thefiscalyear ending June30, 2014,andany succeeding fiscal year, for purposes of computing minimum allowable patient days, utilizationofa facility'scertifiedbedsshall be determinedat aminimum of ninety per cent of capacity, except for new facilities and facilities which are certified for additional beds which may be permitted a lower occupancy rate for the first three months of operation after the effective date of licensure.
(13)For the fiscalyear ending June30, 2014,andany succeeding fiscal year, for purposes of computing minimum allowable patient days, utilizationofa facility'scertifiedbedsshall be determinedat aminimum of ninety per cent of capacity, except for new facilities and facilities which are certified for additional beds which may be permitted a lower occupancy rate for the first three months of operation after the effective date of licensure.
(14) The Commissioner of Social Services shall adjust facility rates from April 1, 1999, to June 30, 1999, inclusive, by a per diem amount representing each facility's allocation of funds appropriated for the purposeofwage,benefitandstaffingenhancement.Afacility'sperdiem allocation of such funding shall be computed as follows:
(14) The Commissioner of Social Services shall adjust facility rates from April 1, 1999, to June 30, 1999, inclusive, by a per diem amount representing each facility's allocation of funds appropriated for the purposeofwage,benefitandstaffingenhancement.Afacility'sperdiem sHB6446 / File No.
263 28 sHB6446 File No.
263 allocation of such funding shall be computed as follows:
(D) the facility's percentage share shall be multiplied by the amount of appropriated wage, benefit and staffing enhancement funding to determine thefacility'sallocated amount;and(E)suchallocated amount shall be divided by the number of days of care paid for by Medicaid on LCO No.
(D) the facility's percentage share shall be multiplied by the amount of appropriated wage, benefit and staffing enhancement funding to determine thefacility'sallocated amount;and(E)suchallocated amount shall be divided by the number of days of care paid for by Medicaid on an annual basis including days for reserved beds specified in the 1998 cost report to determine the per diem wage and benefit rate adjustment amount.Thecommissionermayadjustafacility'sreported1998costand utilization data for the purposes of determining a facility's share of wage, benefit and staffing enhancement funding when reported 1998 information is not substantially representative of estimated cost and utilization data for the fiscal year ending June 30, 2000, due to special circumstances during the 1998 cost report period including change of ownership with a part year cost filing or reductions in facility capacity due to facility renovation projects.
3112 35 of 51 Governor's Bill No6446 an annual basis including days for reserved beds specified in the 1998 cost report to determine the per diem wage and benefit rate adjustment amount.Thecommissionermayadjustafacility'sreported1998costand utilization data for the purposes of determining a facility's share of wage, benefit and staffing enhancement funding when reported 1998 information is not substantially representative of estimated cost and utilization data for the fiscal year ending June 30, 2000, due to special circumstances during the 1998 cost report period including change of ownership with a part year cost filing or reductions in facility capacity due to facility renovation projects.
Any enhancement allocations not applied to facility rates shall not be reallocated to other facilities and suchunallocatedamountsshallbeavailableforthecostsassociatedwith interim rates and other Medicaid expenditures.
Any enhancement allocations not applied to facility rates shall not be reallocated to other facilities and suchunallocatedamountsshallbeavailableforthecostsassociatedwith sHB6446 / File No.
263 29 sHB6446 File No.
263 interim rates and other Medicaid expenditures.
The commissioner shall LCO No.
The commissioner shall compare expenditures for wages, benefits and staffing for the 1998 cost report periodto suchexpendituresinthe1999,2000 and2001 cost report periods to verify whether a facility has applied additional payments to specified enhancements.
3112 36 of 51 Governor's Bill No6446 compare expenditures for wages, benefits and staffing for the 1998 cost report periodto suchexpendituresinthe1999,2000and2001 cost report periods to verify whether a facility has applied additional payments to specified enhancements.
provided the Commissioner of Social Services may, in the commissioner's discretion, and after consultation with the receiver, establish an increased rate for the facility if the commissioner with approval of the Secretary of the Office of Policy and Management determines that such higher rate is needed to keep the facility open and to ensure the health, safety and welfare of the residents at such facility.] (g) The established interim rate to become effective upon sale of any licensed chronic and convalescent home or rest home with nursing supervision for which a receivership has been imposed pursuant to sections 19a-541 to 19a-549, inclusive, shall not exceed the rate in effect for the facility at the time of the imposition of the receivership, subject to any annual increases permitted by this section, provided the Commissioner of Social Services may, in the commissioner's discretion and after consultation with the receiver, establish an increased rate for LCO No.
provided the sHB6446 / File No.
3112 37 of 51 Governor's Bill No6446 the facility if the commissioner, with the approval of the Secretary of the Office of Policy and Management, determines that such higher rate is needed to keep the facility open and to ensure the health, safety and welfare of the residents at such facility.
263 30 sHB6446 File No.
263 Commissioner of Social Services may, in the commissioner's discretion, and after consultation with the receiver, establish an increased rate for the facility if the commissioner with approval of the Secretary of the Office of Policy and Management determines that such higher rate is needed to keep the facility open and to ensure the health, safety and welfare of the residents at such facility.] (g) The established interim rate to become effective upon sale of any licensed chronic and convalescent home or rest home with nursing supervision for which a receivership has been imposed pursuant to sections 19a-541 to 19a-549, inclusive, shall not exceed the rate in effect for the facility at the time of the imposition of the receivership, subject to any annual increases permitted by this section, provided the Commissioner of Social Services may, in the commissioner's discretion and after consultation with the receiver, establish an increased rate for the facility if the commissioner, with the approval of the Secretary of the Office of Policy and Management, determines that such higher rate is needed to keep the facility open and to ensure the health, safety and welfare of the residents at such facility.
Any facility with real property other than land placed in service prior to October 1, 1991, shall, for the fiscal year ending June 30, 1995, receive a rate of return on real property equal to the average of the rates of return applied to real property other than land placed in service for the five years preceding October 1, 1993.
Any facility with real property other than land placed in service prior to October 1, 1991, shall, for the fiscal year ending June 30, 1995, receive a rate of return on sHB6446 / File No.
263 31 sHB6446 File No.
263 real property equal to the average of the rates of return applied to real property other than land placed in service for the five years preceding October 1, 1993.
For the fiscal year ending June 30, 1996, and any LCO No.
For the fiscal year ending June 30, 1996, and any succeeding fiscal year, the allowance for real wage growth, as determined in accordance with subsection (q) of section 17-311-52 of the regulations of Connecticut state agencies, shall not be applied.
3112 38 of 51 Governor's Bill No6446 succeeding fiscal year, the allowance for real wage growth, as determined in accordance with subsection (q) of section 17-311-52 of the regulations of Connecticut state agencies, shall not be applied.
For the fiscal year ending June 30, 2003, rate period, the commissioner shall increase the inflation adjustment for rates made in accordance with subsection (p) of section 17-311-52 of the regulations of Connecticut state agencies to update allowable fiscal year 2001 costs to include a one and one-half per cent inflation factor, except that such increase shall be effective November 1, 2002, and such facility rate in effect for the fiscal year ending June 30, 2002, shall be paid for services provided until October 31, 2002, except any facility that would have been issued a lower rate effective July 1, 2002, than for the fiscal year ending June 30, 2002, due to interim rate status or agreement with the department shall be issued such lower rate effective July 1, 2002,and have such rate updated effective November 1, 2002, in accordance with applicable statutes and regulations.
For the fiscal year ending June 30, 2003, rate period, the commissioner shall increase the inflation adjustment for rates made in accordance with subsection (p) of section 17-311-52 of the regulations of Connecticut state agencies to update allowable fiscal year 2001 costs to include a one and one-half per cent inflation factor, except that such increase shall be effective November 1, 2002, and such facility rate in effect for the fiscal year ending June 30, 2002, shall be paid for services provided until October 31, 2002, except any facility that would sHB6446 / File No.
263 32 sHB6446 File No.
263 have been issued a lower rate effective July 1, 2002, than for the fiscal year ending June 30, 2002, due to interim rate status or agreement with the department shall be issued such lower rate effective July 1, 2002,and have such rate updated effective November 1, 2002, in accordance with applicable statutes and regulations.
Effective upon receipt of all the necessary federal LCO No.
Effective upon receipt of all the necessary federal approvals to secure federal financial participation matching funds associated with the rate increase provided in subdivision (4) of subsection (f) of this section, but in no event earlier than October 1, 2005, and provided the user fee imposed under section 17b-320 is required to be collected, each facility shall receive a rate that is four per cent more than the rate the facility received in the prior fiscal year, except any facility that would have been issued a lower rate effective October 1, 2005, than for the fiscal year ending June 30, 2005, due to interim rate statusor agreement withthedepartment,shallbeissuedsuchlower rate effective October 1, 2005.
3112 39 of 51 Governor's Bill No6446 approvals to secure federal financial participation matching funds associated with the rate increase provided in subdivision (4) of subsection (f) of this section, but in no event earlier than October 1, 2005, and provided the user fee imposed under section 17b-320 is required to be collected, each facility shall receive a rate that is four per cent more than the rate the facility received in the prior fiscal year, except any facility that would have been issued a lower rate effective October 1, 2005, than for the fiscal year ending June 30, 2005, due to interim rate statusor agreement withthedepartment,shallbeissuedsuchlower rate effective October 1, 2005.
Effective October 1, 2006, no facility shall receive a rate that is more than three per cent greater than the rate in effect for the facility on September 30, 2006, except any facility that would have been issued a lower rate effective October 1, 2006, due to interim rate status or agreement with thedepartment,shallbeissuedsuchlower rate effective October 1, 2006.
Effective October 1, 2006, no facility shall receive a rate that is more than three per cent greater than the rate in effect for the facility on September 30, 2006, except any facility that would have been issued a lower rate sHB6446 / File No.
For the fiscal year ending June 30, 2008, each facility shall receive a rate that is two and nine-tenths per cent greater than the rate in effect for the period ending June 30, 2007, except any facility that would have been issued a lower rate effective July 1, 2007, than for the rate period ending June 30, 2007, due to interim rate status, or agreement with the department, shallbeissuedsuchlower rate effective July 1,2007.For the fiscalyear ending June 30,2009,ratesineffect for theperiod ending June 30, 2008, shall remain in effect until June 30, 2009, except any facility that would have been issued a lower rate for the fiscal year ending June 30, 2009, due to interim rate status or agreement with the department, shall be issued such lower rate.
263 33 sHB6446 File No.
For the fiscal years ending June 30, 2010, and June 30, 2011, rates in effect for the period ending June 30, 2009, shall LCO No.
263 effective October 1, 2006, due to interim rate status or agreement with the department,shallbeissuedsuchlower rate effective October 1,2006.
3112 40 of 51 Governor's Bill No6446 remain in effect until June 30, 2011, except any facility that would have been issued a lower rate for the fiscal year ending June 30, 2010, or the fiscal year ending June 30, 2011, due to interim rate status or agreement with the department, shall be issued such lower rate.
For the fiscal year ending June 30, 2008, each facility shall receive a rate that is two and nine-tenths per cent greater than the rate in effect for the period ending June 30, 2007, except any facility that would have been issued a lower rate effective July 1, 2007, than for the rate period ending June 30, 2007, due to interim rate status, or agreement with the department, shallbeissuedsuchlower rate effective July 1,2007.For the fiscalyear ending June 30,2009,ratesineffect for theperiodending June 30, 2008, shall remain in effect until June 30, 2009, except any facility that would have been issued a lower rate for the fiscal year ending June 30, 2009, due to interim rate status or agreement with the department, shall be issued such lower rate.
For the fiscal years ending June 30, 2010, and June 30, 2011, rates in effect for the period ending June 30, 2009, shall remain in effect until June 30, 2011, except any facility that would have been issued a lower rate for the fiscal year ending June 30, 2010, or the fiscal year ending June 30, 2011, due to interim rate status or agreement with the department, shall be issued such lower rate.
For the fiscal years ending June 30, 2016, and June 30, 2017, rates shall not exceed those in effect for the period ending June 30, 2015, except the rate paid to a facility may be higher than the rate paid to the facility for the period ending June 30, 2015, if a capital improvement approved by the Department of Developmental Services, in consultation with the Department of Social Services, for the health or safety of the residents was made to the facility during the fiscal year ending June 30, 2016, or June 30, 2017, to the extent such rate increases are within available appropriations.
For the fiscal years ending June 30, 2016, and June 30, 2017, rates shall not exceed those in sHB6446 / File No.
263 34 sHB6446 File No.
263 effect for the period ending June 30, 2015, except the rate paid to a facility may be higher than the rate paid to the facility for the period ending June 30, 2015, if a capital improvement approved by the Department of Developmental Services, in consultation with the Department of Social Services, for the health or safety of the residents was made to the facility during the fiscal year ending June 30, 2016, or June 30, 2017, to the extent such rate increases are within available appropriations.
For the fiscal years ending June 30, 2018, and June 30, 2019, rates shall not exceed those in effect for the period ending June 30, 2017, except the rate paid to a facility may be higher than the rate paid to the facility for LCO No.
For the fiscal years ending June 30, 2018, and June 30, 2019, rates shall not exceed those in effect for the period ending June 30, 2017, except the rate paid to a facility may be higher than the rate paid to the facility for the period ending June 30, 2017, if a capital improvement approved by the Department of Developmental Services, in consultation with the Department of Social Services, for the health or safety of the residents was made to the facility during the fiscal year ending June 30, 2018, or June 30, 2019, only to the extent such rate increases are within available appropriations.
3112 41 of 51 Governor's Bill No6446 the period ending June 30, 2017, if a capital improvement approved by the Department of Developmental Services, in consultation with the Department of Social Services, for the health or safety of the residents was made to the facility during the fiscal year ending June 30, 2018, or June 30, 2019, only to the extent such rate increases are within available appropriations.
For the fiscal years ending June 30, 2020, and June 30, 2021, rates shall not exceed those in effect for the fiscal year ending June 30, 2019, except the rate paid to a facility may be higher than the rate paid to the facility for the fiscal year ending June 30, 2019, if a capital improvement approved by the Department of Developmental Services, in consultation with the Department of Social Services, for the health or safety of the residents was made to the facility during the fiscal year ending June 30, 2020, or June 30, 2021, only to the extent such rate increases are within available appropriations.
For the fiscal years ending June 30, 2020, and June 30, 2021, rates shall not exceed those in effect for the fiscal year ending June 30, 2019, except the rate paid to a facility may be higher than the rate paid to the facility for the fiscal year ending June 30, 2019, if a capital improvement approved by the Department of Developmental Services, in consultation with the Department of Social Services, for the health or safety of the residents was made to the facility during the fiscal year ending June 30, 2020, or June 30, 2021, only to the extent such rate increasesare withinavailableappropriations.
Any facility that has a significant decrease in land and building costs shall receive a reduced rate to reflect such decrease in land and building costs.
Forthefiscalyearsending June 30, 2022, and June 30, 2023, rates shall not exceed those in effect for the fiscal year ending June 30, 2021, except the rate paid to a facility may be higher than the rate paid to the facility for the fiscal year ending June 30, 2021, if a capital improvement approved by the Department of Developmental Services, in consultation with the Department of Social Services, for the health or safety of the residents was made to the facility during the fiscal year ending June 30, 2022, or June 30, 2023, only to the extent such rate increases are within available appropriations.
For the fiscal years ending June 30, 2012, June 30, 2013, June 30, 2014, June 30, 2015, June 30, 2016, June 30, 2017, June 30, 2018, June 30, 2019, June 30, 2020, [and] June 30, 2021, June 30, 2022, and June 30, 2023, the Commissioner of Social Services may provide fair rent increases to any facility that has undergone a material change in circumstances related to fair rent and sHB6446 / File No.
Any facility that has a significant decrease in land and building costs shall receiveareducedratetoreflectsuchdecreaseinlandandbuilding costs.
263 35 sHB6446 File No.
For the fiscal years ending June 30, 2012, June 30, 2013, June 30, 2014, June 30, 2015, June 30, 2016, June 30, 2017, June 30, 2018, June 30, 2019, June 30, 2020, [and] June 30, 2021, June 30, 2022, and June 30, 2023, the Commissioner of Social Services may provide fair rent increases to any facility that has undergone a material change in circumstances related to fair rent and has an approved certificate of need pursuant to section 17b-352, 17b-353, 17b-354 or 17b-355.
263 hasanapproved certificate ofneedpursuant to section17b-352,17b-353, 17b-354 or 17b-355.
Notwithstanding the provisions of this section, the Commissioner of Social Services may, within available appropriations, increase or decrease rates issued to intermediate care facilities for individuals with intellectual disabilities to reflect a reduction in available appropriations as provided in subsection (a) of LCO No.
Notwithstanding the provisions of this section, the Commissioner of Social Services may, within available appropriations, increase or decrease rates issued to intermediate care facilities for individuals with intellectual disabilities to reflect a reduction in available appropriations as provided in subsection (a) of this section.
3112 42 of 51 Governor's Bill No.6446 this section.
Beginning with the fiscal year ending June 30, 2016, a residential care home shall be reimbursed the greater of the allowable accumulated fair rent reimbursement associated with real property additions and land as calculated on a per day basis or three dollars and ten cents per day if the allowable reimbursement associated with real property additions and land is less than three dollars and ten cents per LCO No.
Beginning with the fiscal year ending June 30, 2016, a sHB6446 / File No.
3112 43 of 51 Governor's Bill No6446 day.
263 36 sHB6446 File No.
263 residential care home shall be reimbursed the greater of the allowable accumulated fair rent reimbursement associated with real property additions and land as calculated on a per day basis or three dollars and ten cents per day if the allowable reimbursement associated with real property additions and land is less than three dollars and ten cents per day.
Beginning with the fiscal year ending June 30, 1999, for the purpose of determining the allowable salary of a related party, the department shall revise the maximum salary to twenty-seven thousand eight hundred fifty-six dollars to be annually inflated thereafter in accordance with section 17-311-52 of the regulations of Connecticut state agencies and beginning with the fiscal year ending June 30, 2001, such allowable salary shall be computed on anhourlybasisandthemaximumnumberofhoursallowedforarelated party other than the proprietor shall be increased from forty hours to forty-eight hours per work week.
Beginning with the fiscal year ending June 30, 1999, for the purpose of determining the allowable salary of a related party, the department shall revise the maximum salary to twenty-seven thousand eight hundred fifty-six dollars to be annually inflated thereafter in accordance with section 17-311-52 of the sHB6446 / File No.
For the fiscal year ending June 30, LCO No.
263 37 sHB6446 File No.
3112 44 of 51 Governor's Bill No6446 2005, each facility shall receive a rate that is two and one-quarter per cent more than the rate the facility received in the prior fiscal year, except any facility that would have been issued a lower rate effective July 1, 2004, than for the fiscal year ending June 30, 2004, due to interim rate status or agreement with the department shall be issued such lower rate effective July 1, 2004.
263 regulations of Connecticut state agencies and beginning with the fiscal year ending June 30, 2001, such allowable salary shall be computed on anhourlybasisandthemaximumnumberofhoursallowedforarelated party other than the proprietor shall be increased from forty hours to forty-eight hours per work week.
For the fiscal year ending June 30, 2005, each facility shall receive a rate that is two and one-quarter per cent more than the rate the facility received in the prior fiscal year, except any facility that would have been issued a lower rate effective July 1, 2004, than for the fiscal year ending June 30, 2004, due to interim rate status or agreement with the department shall be issued such lower rate effective July 1, 2004.
For the fiscal years ending June 30, 2010, and June 30, 2011, rates in effect for the period ending June 30, 2009, shall remain in effectuntilJune30,2011,exceptanyfacilitythatwouldhavebeenissued a lower rate for the fiscal year ending June 30, 2010, or the fiscal year ending June 30, 2011, due to interim rate status or agreement with the department, shall be issued such lower rate, except [(i)] (A) any facility LCO No.
For the fiscal years ending June 30, 2010, and June 30, sHB6446 / File No.
3112 45 of 51 Governor's Bill No6446 that would have been issued a lower rate for the fiscal year ending June 30, 2010, or thefiscalyear ending June30,2011,due tointerimratestatus or agreement with the Commissioner of Social Services shall be issued such lower rate;
263 38 sHB6446 File No.
263 2011, rates in effect for the period ending June 30, 2009, shall remain in effectuntilJune30,2011,exceptanyfacilitythatwouldhavebeenissued a lower rate for the fiscal year ending June 30, 2010, or the fiscal year ending June 30, 2011, due to interim rate status or agreement with the department, shall be issued such lower rate, except [(i)] (A) any facility that would have been issued a lower rate for the fiscal year ending June 30, 2010, or thefiscalyear ending June30,2011,due tointerimratestatus or agreement with the Commissioner of Social Services shall be issued such lower rate;
No facility shall be issued a rate that is lower than the rate in effect on June 30, 2013, except that any facility that would have been issued a lower rate for the fiscal year ending June 30, 2014, or the fiscal year ending June 30, 2015, due to interim rate status or agreement with the commissioner, shall be issued such lower rate.
No facility shall be issued a rate that is lower than the rate in effect on sHB6446 / File No.
For the fiscal year ending June 30, 2014, and each fiscal year thereafter, a residential care home LCO No.
263 39 sHB6446 File No.
3112 46 of 51 Governor's Bill No6446 shall receive a rate increase for any capital improvement made during the fiscal year for the health and safety of residents and approved by the Department of Social Services, provided such rate increase is within available appropriations.
263 June 30, 2013, except that any facility that would have been issued a lower rate for the fiscal year ending June 30, 2014, or the fiscal year ending June 30, 2015, due to interim rate status or agreement with the commissioner, shall be issued such lower rate.
For the fiscal year ending June 30, 2014, and each fiscal year thereafter, a residential care home shall receive a rate increase for any capital improvement made during the fiscal year for the health and safety of residents and approved by the Department of Social Services, provided such rate increase is within available appropriations.
For the fiscal years ending June 30, 2016, and June 30, 2017, and each succeeding fiscal year, any facility that would have been issued a lower rate, due to interim rate status,achangeinallowablefairrentoragreementwiththedepartment, shall be issued such lower rate.
For the fiscal years ending sHB6446 / File No.
For the fiscal year ending June 30, 2018, rates shall not exceed those in effect for the period ending June 30, 2017, LCO No.
263 40 sHB6446 File No.
3112 47 of 51 Governor's Bill No.6446 except the commissioner may, in the commissioner's discretion and within available appropriations, provide pro rata fair rent increases to facilities which have documented fair rent additions placed in service in the cost report year ending September 30, 2016, that are not otherwise included in rates issued.
263 June 30, 2016, and June 30, 2017, and each succeeding fiscal year, any facility that would have been issued a lower rate, due to interim rate status,achangeinallowablefairrentoragreementwiththedepartment, shall be issued such lower rate.
For the fiscal year ending June 30, 2018, rates shall not exceed those in effect for the period ending June 30, 2017, except the commissioner may, in the commissioner's discretion and within available appropriations, provide pro rata fair rent increases to facilities which have documented fair rent additions placed in service in the cost report year ending September 30, 2016, that are not otherwise included in rates issued.
For the fiscal year ending June 30, 2022, rates shall not exceed those in effect for the fiscal year ending June 30, 2021, except the commissioner may, in the commissioner's discretion and within available appropriations, provide pro rata fair rent increases to facilities which have documented fair rent additions placed in service in the cost report year ending September 30, 2020, that are not otherwise included in rates issued.
For the fiscal year ending June 30, 2022, the commissioner may, in the commissioner's discretion and within available appropriations, provide pro rata fair rent increases to facilities which have documented fair rent additions placed in service in the cost report year ending September 30, 2020, that are not otherwise included in rates issued.
For the fiscal year ending June 30, 2023, rates shall not exceed those in effect for the fiscal year ending June 30, 2022, except the commissioner may, in the commissioner's discretion and within available appropriations, provide pro rata fair rent increases to facilities which have documented fair rent additions placed in service in the cost report year ending September 30, 2021, that are not otherwise included in rates issued.
For the fiscal year ending June 30, 2023, the commissioner may, in the commissioner's discretion and within available appropriations, provide pro rata fair rent increases to facilities sHB6446 / File No.
LCO No.
263 41 sHB6446 File No.
3112 48 of 51 Governor's Bill No6446 [(2) The commissioner shall, upon determining that a loan to be issued to a residential care home by the Connecticut Housing Finance Authority is reasonable in relation to the useful life and property cost allowance pursuant to section 17-311-52 of the regulations of Connecticut state agencies, allow actual debt service, comprised of principal, interest and a repair and replacement reserve on the loan, in lieu of allowed property costs whether actual debt service is higher or lower than such allowed property costs.
263 which have documented fair rent additions placed in service in the cost report year ending September 30, 2021, that are not otherwise included in rates issued.
[(2) The commissioner shall, upon determining that a loan to be issued to a residential care home by the Connecticut Housing Finance Authority is reasonable in relation to the useful life and property cost allowance pursuant to section 17-311-52 of the regulations of Connecticut state agencies, allow actual debt service, comprised of principal, interest and a repair and replacement reserve on the loan, in lieu of allowed property costs whether actual debt service is higher or lower than such allowed property costs.
The fee schedule may be adjusted annually beginning July 1, 1997, to reflect necessary increases in the cost of services.] (j) Notwithstanding the provisions of this section, state rates of payment for the fiscal years ending June 30, 2018, June 30, 2019, June 30, 2020, [and] June 30, 2021, June 30, 2022, and June 30, 2023, for residential carehomesandcommunitylivingarrangementsthatreceivetheflatrate for residential services under section 17-311-54 of the regulations of Connecticut state agencies shall be set in accordance with section [298 of public act 19-117] 6 of this act.
The fee schedule may be adjusted annually beginning July 1, 1997, to reflect necessary increases in the cost of services.] (j) Notwithstanding the provisions of this section, state rates of payment for the fiscal years ending June 30, 2018, June 30, 2019, June 30, 2020, and June 30, 2021, for residential care homes and community living arrangements that receive the flat rate for residential services under section 17-311-54 of the regulations of Connecticut state agencies shall be set in accordance with section 298 of public act 19-117.
9.
4.
(a) Notwithstanding the provisions of chapter 368z, New Horizons, Inc., a nonprofit, nonsectarian organization, or a subsidiary organization controlled by New Horizons, Inc., is authorized to construct and operate an independent living facility for severely physically disabled adults, in the town of Farmington, provided such facility shall be constructed in accordance with applicable building codes.
(a) Notwithstanding the provisions of chapter 368z, New Horizons, Inc., a nonprofit, nonsectarian organization, or a subsidiary organization controlled by New Horizons, Inc., is authorized to construct and operate an independent living facility for severely physically disabled adults, in the town of Farmington, provided such facility shall be constructed in accordance with applicable building sHB6446 / File No.
The Farmington Housing Authority, or any issuer acting on behalf of said authority, subject to the provisions of this section, may LCO No.
263 42 sHB6446 File No.
3112 49 of 51 Governor's Bill No6446 issue tax-exempt revenue bonds on a competitive or negotiated basis for the purpose of providing construction and permanent mortgage financing for the facility in accordance with Section 103 of the Internal Revenue Code.
263 codes.
The Farmington Housing Authority, or any issuer acting on behalf of said authority, subject to the provisions of this section, may issue tax-exempt revenue bonds on a competitive or negotiated basis for the purpose of providing construction and permanent mortgage financing for the facility in accordance with Section 103 of the Internal Revenue Code.
The facility shall report on a fiscal year ending on the thirtieth day of September onformsprovidedby thecommissioner.The requiredreport shall be received by the commissioner no later than December thirty- first of each year.
The facility shall report on a fiscal year ending on the thirtieth day of September onformsprovidedby thecommissioner.The requiredreport shall be received by the commissioner no later than December thirty- sHB6446 / File No.
263 43 sHB6446 File No.
263 first of each year.
If the LCO No.
If the facility is aggrieved by any decision of the commissioner, the facility may, within ten days, after written notice thereof from the commissioner, obtain by written request to the commissioner, a hearing on all items of aggrievement.
3112 50 of 51 Governor's Bill No.
6446 facility is aggrieved by any decision of the commissioner, the facility may, within ten days, after written notice thereof from the commissioner, obtain by written request to the commissioner, a hearing on all items of aggrievement.
Section 1 July 1, 2021 17b-104(b) Sec.
Section 1 July 1, 2021 17b-265 Sec.
2 July 1, 2021 17b-106(a) Sec.
2 October 1, 2021 17b-340d Sec.
3 August 1, 2022 17b-256f Sec.
3 July 1, 2021 17b-340 Sec.
4 July 1, 2021 17b-265 Sec.
4 July 1, 2021 19a-507(a) HS Joint Favorable Subst.
5 July 1, 2021 17b-244 Sec.
sHB6446 / File No.
6 July 1, 2021 New section Sec.
263 44 sHB6446 File No.
7 July 1, 2021 17b-340d Sec.
263 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.
8 July 1, 2021 17b-340 Sec.
In general, fiscal impacts are based upon a variety of informational sources, including the analyst’s professional knowledge.
9 July 1, 2021 19a-507(a) Statement of Purpose:
Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.
To implement the Governor's budget recommendations for human services.
OFA Fiscal Note State Impact:
[Proposed deletions are enclosed in brackets.
Agency Affected Fund-Effect FY 22 $ FY 23 $ Social Services, Dept.
Proposed additions are indicated by underline, except underlined.]e entire text of a bill or resolution or a section of a bill or resolution is new, it is not LCO No.
GF - Savings $2 million $12.2 million Note:
3112 51 of 51
GF=General Fund Municipal Impact:
None Explanation The bill is anticipated to result in state Medicaid savings of approximately $2 million in FY 22 and $12.2 million in FY 23 to the Department of Social Services as follows:
(1) approximately $2 million in FY 22 and $1 million in FY 23 associated with additional reimbursement for services paid by third party insurers due to the implementation of prompt payment standards, and (2) approximately $11.2 million in FY 23 due to limiting rate increases for nursing homes.
The bill also requires the implementation of acuity-based rates for nursing homes, which is not anticipated to result in a fiscal impact to the state as the transition to acuity-based reimbursement must be cost neutral.
The bill makes other technical and conforming changes that have no fiscal impact.
The Out Years The annualized ongoing fiscal impact identified above would continue into the future subject to inflation.
sHB6446 / File No.
263 45 sHB6446 File No.
263 OLR Bill Analysis sHB 6446 AN ACT CONCERNING THE GOVERNOR'S BUDGET RECOMMENDATIONS FOR HUMAN SERVICES.
SUMMARY This bill requires the Department of Social Services (DSS) to implement acuity-based Medicaid rates for nursing homes beginning in the second quarter of FY 22 (i.e., October 1, 2021), thus replacing current law's cost-based rates.
It establishes categories and limits for allowable cost components for acuity-based rates and requires DSS, through regulations, to establish peer groupings of facilities for calculating certain allowable costs.
The bill also eliminates certain hearing and reporting requirements for cost-based rate determinations for residential care homes and intermediate care facilities for individuals with intellectual disabilities (ICF-IDs).
It allows the DSS commissioner to provide certain fair rent increasesto (1)ICF-IDsandresidentialcare homesfor FYs 22and23and (2) nursing homes for the final nine months of FY 22.
Additionally, the bill establishes deadlines for insurers and other legally liable third parties to (1) act on claims DSS submits for covered health care items and services and (2) request refunds from DSS when they determine they are not liable for a claim for which they reimbursed DSS.
Lastly, the bill eliminates obsolete provisionsand makes other minor, conforming, and technical changes.
EFFECTIVE DATE:
July 1, 2021, except provisions implementing acuity-based rates for nursing homes are effective October 1, 2021.
sHB6446 / File No.
263 46 sHB6446 File No.
263 §§ 2 & 3 — ACUITY-BASED MEDICAID RATES FOR NURSING HOMES Transition to Acuity-Based Rates Current law requires DSS to annually determine cost-based rates for room, board, and services provided by nursing homes, residential care homes, and ICF-IDs and allows DSS to establish acuity-based rates for nursinghomes.BeginningwiththesecondquarterofFY22(i.e.,October 1, 2021), the bill requires, rather than allows, DSS to establish acuity- based rates.
(Generally, acuity-based rates refer to rates that vary based on, among other things, the facility's patient case mix.) It requires that the transition to acuity-based rates be cost-neutral and based on FY 18 cost reports.
The bill requires DSS to base rates on cost years ending September 30.
When establishing these rates, DSS must (1) make or phase in case-mix adjustments to the direct care component of rates, effective October 1, 2021, and update them quarterly and (2) establish geographic peer groupingsoffacilities under regulationsthedepartment adopts.The bill requires that the acuity-based rates DSS establishes comply with federal law and regulations.
The bill establishes five cost components for allowable costs under the acuity-based rates.
Current law establishes similar components for cost-basedratemaking.However,thebill'sacuity-basedprovisionslimit them as shown in Table 1:
Table 1:
Cost Components for Acuity-Based Ratemaking Component Included Costs Limit Direct costs Nursing personnel salaries 135% of the median allowable and related fringe benefits cost in the applicable peer and nursing pool costs grouping Indirect costs Professional fees, dietary 115% of the statewide median expenses, housekeeping and allowable cost laundry expenses, patient care supplies, and salaries sHB6446 / File No.
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263 and related fringe benefits for indirect care personnel Fair rent Defined in regulations Calculated using the amount adopted by the department approved through DSS’s certificate of need process Capital-related Property taxes, insurance No maximum limit costs expenses, equipment leases, and equipment depreciation Administrative Plant maintenance and State-wide median allowable and general costs operation expenses, and cost salaries and related fringe benefits for administrative and maintenance personnel Other Requirements The bill requires DSS to determine a facility’s certified bed utilization at a minimum of 90% of capacity for purposes of computing minimum allowable patient days.
New facilities and facilities certified for additional beds may be permitted a lower occupancy rate for the first three months of operation after their licensure becomes effective.
The bill prohibits inflationary rate increases to nursing homes for FYs and 23 once acuity-based ratemaking becomes effective (i.e., October 1, 2021 to June 30, 2023).
However, it allows the DSS commissioner, in her discretion and within available appropriations, to provide proportional fair rent increases in the final three quarters of FY 22 (i.e., October 1, 2021 to June30,2022)to nursing homeswith documented fair rent additionsplaced inservice inthecostreportyear ending September 30, 2019, that are not otherwise included in the issued rates.
§§ 3 & 4 — COST-BASED RATEMAKING General Provisions By law, nursing homes, residential care homes, and ICF-IDs must submit annual reports to DSS on their costs, and, for nursing homes, sHB6446 / File No.
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263 information on certain related parties doing business with the facilities.
For nursing homes, the bill appears to eliminate these statutory reporting requirements once acuity-based ratemaking becomes effective.Forallfacilities,thebilleliminatesarequirementthatDSShold a public hearing before making its annual cost-based rate determinations.
Current law requires DSS to report the data in facility reports to the Appropriations Committee annually by April 1.
The bill instead requires DSS report this data on its website.
Current law requires DSS to adopt regulations to specify any other allowable services required by a medical assistance beneficiary living in a facility but not already covered in cost-based rates.
The bill instead allows DSS to implement policies and procedures as necessary to carry out provisions on cost-based ratemaking broadly for facilities under existing law and under the bill.
DSS must publish notice of intent to adopt regulations on the eRegulations System within 20 days after implementing the policy or procedure.
The bill also eliminates a provision in current law requiring the DSS commissionertoallowresidentialcarehomestousedebtserviceinstead of allowable property costs if she determines that a loan to be issued to the home by the Connecticut Housing Finance Authority is reasonable.
FYs 22 and 23 Rates For ICF-IDs, the bill extends, for FYs 22 and 23, a provision in current law allowing the DSS commissioner to provide fair rent increases to facilities that have undergone a material change in circumstances related to fair rent with an approved certificate of need.
For residential care home rates for FY 22, the bill allows the DSS commissioner, in her discretion and within available appropriations, to provide proportional fair rent increases to facilities with documented fair rent additions placed in service in the cost year ending September 30, 2020, that are not otherwise included in the rates.
For FY 23, the bill allows the commissioner to do the same for documented fair rent additions placed in service in the cost year ending September 30, 2021.
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263 § 1 — INSURER DEADLINES FOR DSS CLAIMS Existing law authorizes DSS to recover claims from an insurer or other legally liable third party when the state pays for a health care service for which the third party is legally responsible.
The bill requires these entities to act on a claim submitted by DSS for payment for health care items or services covered by a state medical assistance program within the later of 90 days after receiving the claim or September 29, 2021.
Within this timeframe, these entities must (1) make a payment on the claim, (2) request necessary information to determine its legal obligation to pay the claim, or (3) issue a written reason for denying the claim.
If the entity fails to act on a claim within the later of 120 days of receiving a claim or October 29, 2021, the failure creates an uncontestable obligation to pay the claim.
The bill applies these provisions to all DSS claims, including those submitted before July 1, 2021.
Thebillalsoestablishesadeadlineforinsurersandotherlegallyliable third parties to request a refund from DSS if they determine they are not liable for the cost of a health care item or service for which they have reimbursed the department.
It requires these entities to request refunds from DSS within 12 months after the reimbursement date.
COMMITTEE ACTION Human Services Committee Joint Favorable Substitute Yea 19 Nay 0 (03/18/2021) sHB6446 / File No.
263 50
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Action History

  1. REF. BY HOUSE TO COMMITTEE ON Appropriations

  2. FILE NO. 263

  3. HOUSE CALENDAR NUMBER 217

  4. FAV. RPT., TABLED FOR HOUSE CALENDAR

  5. RPTD. OUT OF LCO

  6. REFERRED TO Office of Legislative Research AND Office of Fiscal Analysis 04/06/21

  7. FILED WITH LCO

  8. Joint Favorable Substitute

  9. PUBLIC HEARING 0304

  10. REF. TO JOINT COMM. ON Human Services

Sponsors

  • Request Of The Governor Pursuant To Joint Rule 9 · Primary

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1 sponsors · 0 co-sponsors · 186 not signed on

Sponsors (1)

  • Request Of The Governor Pursuant To Joint Rule 9

Co-sponsors (0)

None.

Not signed on (186)

186 members have not signed on to this bill.

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"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

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Who sponsors HB 6446?
HB 6446 is sponsored by Request Of The Governor Pursuant To Joint Rule 9.
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This bill died with 2021 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
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