BY SENATORS Rizzuto, Blickensderfer, and Lacy;
also REPRESENTATIVES Owen, Grampsas, Romero, Alexander,
Epps, and Lawrence.
CONCERNING THE EXCLUSION OF DIRECT MEDICARE PART
B COSTS FROM ALLOWABLE MEDICAID REIMBURSEMENT TO CERTAIN NURSING
FACILITIES.
Be it enacted by the General Assembly of the State
of Colorado:
SECTION 1. 264410
(4) (d) (I) and (4) (d) (II) (B), Colorado Revised Statutes, are
amended to read:
264410. Providers
nursing facility nursing facility patient program improvement
fund reimbursement maximum allowable quality
of care incentive payment program legislative declaration
repeal. (4) (d) (I) The
general assembly finds that the historical growth in nursing facility
rates has significantly exceeded the rate of inflation. These
increases have been caused in part by the inclusion of Medicare
costs in Medicaid cost reports. The state of Colorado has an
interest in limiting these exceptional increases in Medicaid nursing
facility rates by imposing growth ceilings on nursing facility
rates, instituting a casemix reimbursement system, removing
Medicare part B DIRECT costs from the Medicaid nursing facility
rates, and imposing a ceiling on the Medicare part A ancillary
costs which
THAT are included in calculating Medicaid nursing facility rates.
(II) Notwithstanding any other provision
in this article, the following limitations shall apply to rates
for reimbursement of nursing facilities:
(B) For all rates effective on or after
July 1, 1997, for each class I and class V facility, only such
costs as are reasonable, necessary, and patientrelated may
be reported for reimbursement purposes. Nursing facilities may
include whatever level of Medicare part A ancillary costs was
included and allowed in the facility's latest Medicaid cost report
filed prior to July 1, 1997. Any subsequent increase in this
amount shall be limited to either the increase in the facility's
allowable Medicare part A ancillary costs or the percentage increase
in the cost of medical care reported in the United States department
of labor bureau of labor statistics consumer price index for the
same time period, whichever is lower. Part B DIRECT costs for
Medicare shall be excluded from the allowable reimbursement for
facilities.
SECTION 2. Safety
clause. The general assembly hereby finds, determines, and
declares that this act is necessary for the immediate preservation
of the public peace, health, and safety.
____________________________ ____________________________
Tom Norton Charles E. Berry
PRESIDENT OF SPEAKER OF THE HOUSE
THE SENATE OF REPRESENTATIVES
____________________________ ____________________________
Patricia K. Dicks Judith M. Rodrigue
ASSISTANT SECRETARY OF CHIEF CLERK OF THE HOUSE
THE SENATE OF REPRESENTATIVES
APPROVED________________________________________
_________________________________________
Roy Romer
GOVERNOR OF THE STATE
OF COLORADO