HF1419

Purpose

This bill aims to modify how elderly waiver programs and nursing facility reimbursements are paid by changing what counts as fixed costs in rate calculations. By expanding the categories considered “external fixed costs,” the legislation seeks to influence the funding levels and payment rates for these services.

Main Provisions

• Redefinition of External Fixed Costs:
  • The bill amends Minnesota Statutes to redefine “External fixed costs” and to include a broad list of cost areas that will be treated as fixed costs in rate calculations for elderly waiver and nursing facility reimbursements.
• Expanded List of Included Cost Categories:
  • The following items are added to the external fixed costs definition:
  • Nursing home surcharge (section 256.9657, subdivision 1)
  • Licensure fees (section 144.122)
  • Family advisory council fee (section 144A.33)
  • Scholarships (section 256R.37)
  • Planned closure rate adjustments (section 256R.40)
  • Consolidation rate adjustments (section 144A.071, subdivisions 4c and 4d)
  • Single-bed room incentives (section 256R.41)
  • Property taxes, special assessments, and payments in lieu of taxes
  • Employer health insurance costs
  • Quality improvement incentive payments (section 256R.39)
  • Performance-based incentive payments (section 256R.38)
  • Special dietary needs (section 256R.51)
  • Public Employees Retirement Association employer costs and border city rate adjustments (section 256R.481)
  • Rate adjustments related to nursing home wage standards (section 256R.495.1)
• New Codification and Structure:
  • The bill adds new subdivisions to several statutes (including 256R.23 subdivisions 2-3; 256R.24 subdivision 1; 256R.25; 256S.211 subdivisions 1-2; 256S.213 subdivision 1) and proposes coding for new law in Minnesota Statutes chapter 256R.1.7. This establishes the framework for implementing the expanded external fixed costs in rate settings.
• Relationship to Rates:
  • By including these items as external fixed costs, the bill changes the components that drive elderly waiver and nursing facility reimbursement rates, potentially affecting the total funds paid to facilities and program participants.

Significant Changes to Existing Law

• Broader Definition of Costs:
  • The definition of External fixed costs is expanded to explicitly incorporate a wide range of fees, taxes, wage-related costs, and incentive payments that facilities incur, which were not all previously categorized under fixed costs for rate-setting purposes.
• Statutory Infrastructure:
  • Creation of new subdivisions and codification steps to implement the expanded cost categories, ensuring these items are consistently treated as external fixed costs in rate calculations under the applicable sections of the Minnesota Rules and Statutes.

Implementation Considerations

• Scope of Impact:
  • The change focuses on rate-setting for elderly waiver services and nursing facility reimbursements, which could shift funding responsibilities and reimbursement levels across providers and affected programs.
• Timing and Application:
  • The exact effective dates and implementation details would depend on enactment and subsequent rulemaking or administrative guidance, which are not specified in the excerpt.

Overview

• The bill is centered on adjusting how certain costs are treated in rate calculations for elderly waiver and nursing facility payments by expanding what counts as external fixed costs. It lists numerous specific cost categories and creates new statutory subdivisions to support this framework.

Relevant Terms - External fixed costs - Elderly waiver rates - Nursing facility reimbursement rates - Nursing home surcharge - Licensure fees - Family advisory council fee - Scholarships - Planned closure rate adjustments - Consolidation rate adjustments - Single-bed room incentives - Property taxes - Special assessments - Payments in lieu of taxes - Employer health insurance costs - Quality improvement incentive payments - Performance-based incentive payments - Special dietary needs - Public Employees Retirement Association employer costs - Border city rate adjustments - Nursing home wage standards - Rate adjustments - Minnesota Statutes 256R.02 Subdivision 19 - Minnesota Statutes chapters 256R and 256S - New subdivisions: 256R.23, 256R.24, 256R.25, 256S.211, 256S.213 - Chapter 256R.1.7 coding - 144A.33, 144A.071, 144A.071 subdivisions 4c, 4d - 256R.37, 256R.38, 256R.39, 256R.40, 256R.41, 256R.481, 256R.495.1 - 256.9657, 256R.41, 256R.37, 256R.38, 256R.39, 256R.51