SENATE BILL No. 1037

 

 

May 30, 2018, Introduced by Senators MACGREGOR, STAMAS and HANSEN and referred to the Committee on Oversight.

 

 

 

     A bill to amend 1939 PA 280, entitled

 

"The social welfare act,"

 

(MCL 400.1 to 400.119b) by adding section 111n.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 111n. (1) If the department changes how it interprets

 

existing Medicaid provider policy, that change in policy must be

 

processed in the same manner that the department uses when

 

promulgating new Medicaid provider policy. This process shall

 

include, but is not limited to, allowing Medicaid providers the

 

opportunity to comment on the change of policy and providing a

 

prospective effective date for the change of policy.

 

     (2) The department shall establish a bed escrow program that

 

allows a nursing facility to set aside beds for not less than 10

 

years without having to reestablish or relinquish the beds. This

 

program shall not require the beds set aside to be contiguous and

 

shall replace the current Medicaid policy for nonavailable bed

 

plans for a nursing facility.

 

     (3) The department shall allow the entire nursing facility to

 

be utilized during the period when the nursing facility has a bed

 

in the bed escrow program described in subsection (2).

 

     (4) The department shall establish a current asset value bed

 

limit using a rolling 10-year history of new construction.

 

     (5) The department shall establish a process to automatically

 

change the level of care code in the community health automated

 

Medicaid processing system (CHAMPS) immediately when a filing has

 

been made to disenroll a nursing facility resident from a health

 

maintenance organization and the resident has completed 45 days of

 

care at the nursing facility.

 

     (6) Within 60 days after receipt of a request from a nursing

 

facility, the department shall perform a secondary review of a

 

denied rate exception, including, but not limited to, rate relief,

 

or application of a classwide average rate. The secondary review

 

required under this subsection must be performed by the director of

 

the office of audit.

 

     (7) The department shall conduct a quarterly meeting and

 

invite appropriate stakeholders. Appropriate stakeholders shall

 

include at least 1 representative from each nursing facility

 

provider trade association, and any other experts. Individuals who

 

participate in these quarterly meetings, in conjunction with the

department, may designate advisory workgroups to develop

 

recommendations on the discussion topics that should include, at a

 

minimum, the following:

 

     (a) Seeking quality improvement to the cost report audit and

 

settlement process, including clarification to process-related

 

policies and protocols that include, but are not limited to, the

 

following:

 

     (i) Improving the auditors' quality and preparedness.

 

     (ii) Enhanced communication between department staff and

 

providers.

 

     (b) Promoting transparency between providers and department

 

staff, including, but not limited to, applying regulations and

 

policy in an accurate, consistent, and timely manner and evaluating

 

changes that have been implemented to resolve any identified

 

problems and concerns.

 

     Enacting section 1. This amendatory act takes effect 90 days

 

after the date it is enacted into law.