AB 99 — Revises provisions governing Medicaid rates of reimbursement. (BDR 38-564)

EXEMPT (Reprinted with amendments adopted on April 13, 2023) FIRST REPRINT A.B.

requiring the DirectorDivision of Health Care Financing and Policy of the Department of Health and Human Services to takereport anycertain actioninformation necessary to increasethe certainLegislature; federally approved rates under certain circumstances;

providing for thea annualstudy considerationon of cost-of-living increases to rates of reimbursement provided to certain providers under Medicaid;

§ 1396a) SectionExisting 1law of this bill requires the DirectorDivision of theHealth Department,Care uponFinancing approvingand anPolicy increaseof in the rateDepartment ofto reimbursementreview paidthe foradequacy aof service or item under Medicaid toreimbursement Secretaryrates forevery that4 serviceyears or item, tocalculate takethe anyrate actionof necessaryreimbursement tothat obtainaccurately areflects corresponding increase in the maximumactual federallycost approvedof reimbursementproviding ratethe for that service or item.

Section(NRS 1422.2704) alsoSection requires2.3 that the Division of Healththis Carebill Financingrequires andthe PolicyDivision ofto thesubmit Departmenta annuallyreport considerconcerning cost-of-livingeach increasessuch review to Medicaidthe ratesLegislature. of reimbursement.

Section 22.6 of this bill makesrequires athe conformingDivision change to indicateconduct a study during the proper2023-2024 placementlegislative ofinterim sectionto 1determine inthe cost to the NevadaState RevisedGeneral Statutes.Fund of providing:

-(1) *AB99*a –one-time 2cost-of-living –increase THEto PEOPLEthe OFrates THEof STATEreimbursement OFunder NEVADA,Medicaid REPRESENTEDfor INrates SENATEof ANDreimbursement.providers; ASSEMBLY, DO ENACT AS FOLLOWS:

and (2) an annual cost-of-living increase to such - *AB99_R1* – 2 – THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

Chapter(Deleted 422 of NRS is hereby amended by addingamendment.) theretoSec. a new section to read as follows:

1.

If the Director approves an increase in the rate of reimbursement for a service or item provided under the State Plan for Medicaid to an amount that is greater than the maximum rate of reimbursement approved by the Secretary of Health and Human Services for that service or item, the Director shall take any action necessary, including, where applicable, applying to amend a federal waiver, to increase the maximum rate of reimbursement approved by the Secretary to an amount equal to or greater than the rate of reimbursement approved by the Director.

The(Deleted Divisionby shallamendment.) annuallySec. review whether the rate of reimbursement for each service or item provided under the State Plan for Medicaid should be increased to compensate for an increase in the cost of living.

2.3.

NRS 422.2704 is hereby amended to read as follows:

422.2704 1.

On or before January 1, 2018, and every 4 years thereafter, the Division shall:

[1.] (a) Review the rate of reimbursement for each service or item provided under the State Plan for Medicaid to determine whether the rate of reimbursement accurately reflects the actual cost of providing the service or item;

and [2.] (b) If the Division determines that the rate of reimbursement for a service or item does not accurately reflect the actual cost of providing the service or item, calculate the rate of reimbursement that accurately reflects the actual cost of providing the service or item and recommend that rate to the Director for possible inclusion in the State Plan for Medicaid.

2.

On or before January 31, 2026, and every 4 years thereafter, the Division shall:

(a) Compile a report on the most recent reviews conducted pursuant to subsection 1, including, without limitation, each rate of reimbursement calculated pursuant to paragraph (b) of subsection 1;

and (b) Submit the report to the Director of the Legislative Counsel Bureau for transmittal to the Interim Finance Committee and the Joint Interim Standing Committee on Health and Human Services.

2.6.

1.

During the 2023-2024 interim, the Division of Health Care Financing and Policy of the Department of Health and Human Services shall conduct a study to determine the cost to the Sta(a) Increasing the rates of reimbursement provided to long-term care providers under Medicaid to account for any increase in the cost of living that has occurred since the date on which the rate of reimbursement was most recently established for such providers;

and (b) Annually adjusting the rates of reimbursement provided to long-term care providers under Medicaid to account for increases in the cost of living.

NRSOn 232.320or isbefore herebyNovember amended15, to2024, readthe asDivision follows:of Health Care Financing and Policy of the Department of Health and Human Services shall:

232.320- 1.*AB99_R1* – 3 – pursuant to subsection 1 and any recommendations for legislation resulting from the study;

Theand Director:(b) Submit the report to the Director of the Legislative Counsel Bureau for transmittal to the Interim Finance Committee and the 83rd Session of the Legislature.

(a)3. Shall appoint, with the consent of the Governor, administrators of the divisions of the Department, who are respectively designated as follows:

(1)As Theused Administratorin ofthis section, “long-term care provider” means a provider providing services pursuant to the Aginghome and Disabilitycommunity- Servicesbased Division;services waiver granted pursuant to 42 U.S.C.

(2)§ The1396n, Administratorincluding, ofwithout thelimitation, Divisionhome ofhealth Welfareservices and Supportiveprivate Services;duty nursing services.

(3) The Administrator of the Division of Child and Family Services;

(4) The Administrator of the Division of Health Care Financ(5) The Administrator of the Division of Public and Behavioral Health.

(b) Shall administer, through the divisions of the Department, the provisions of chapters 63, 424, 425, 427A, 432A to 442, inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and section 1 of this act, 422.580, 432.010 to 432.133, inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, and 445A.010 to 445A.055, inclusive, and all other provisions of law relating to the functions of the divisions of the Department, but is not responsible for the clinical activities of the Division of Public and Behavioral Health or the professional line activities of the other divisions.

- *AB99* – 3 – (c) Shall administer any state program for persons with developmental disabilities established pursuant to the Developmental Disabilities Assistance and Bill of Rights Act of 2000, 42 U.S.C.

§§ 15001 et seq.

(d) Shall, after considering advice from agencies of local governments and nonprofit organizations which provide social services, adopt a master plan for the provision of human services in this State.

The Director shall revise the plan biennially and deliver a copy of the plan to the Governor and the Legislature at the beginning of each regular session.

The plan must: