Nursing facilities, privilege assessments and surcharge on each nursing home bed, assessment extended, to August 31, 2028
Summary
HB405 extends Alabama’s existing nursing facility provider assessments, including the supplemental privilege assessment, secondary supplemental privilege assessment, and related surcharge, through August 31, 2028. These assessments are charged on a per-bed basis to nursing facilities and are tied to the state’s Medicaid financing structure. The bill also keeps in place the mechanism that treats these assessments as allowable costs for Medicaid reimbursement, so nursing facilities can have the assessed amounts reflected in their Medicaid per diem rates.
The bill further states that, during the period these assessments are levied and collected, the Alabama Medicaid Agency will directly administer the Medicaid nursing facility program. In practical terms, the legislation preserves the current financing and reimbursement arrangement for nursing homes and extends the timeline for the state’s provider-tax-supported Medicaid funding model without changing the basic structure of the assessments themselves.
Impact
HB405 amends Section 40-26B-21 of the Code of Alabama 1975 to move the expiration date for the supplemental privilege assessment, secondary supplemental privilege assessment, and surcharge from August 31, 2025, to August 31, 2028. It also reinforces that these payments remain allowable costs under Medicaid reimbursement rules and that corresponding per diem adjustments continue to be made for nursing facilities. The bill affects nursing homes, the Alabama Medicaid Agency, and the state’s Medicaid financing system by extending a revenue source used to support indigent health care and Medicaid operations.
Sentiment
The bill appears to have been broadly supported and noncontroversial. It passed the House of Origin and the second house unanimously, with 100-0 and 31-0 votes, respectively. The voting history suggests strong bipartisan agreement to continue the existing nursing facility assessment structure and Medicaid funding arrangement.
Contention
No major opposition is reflected in the available record, and there are no committee transcript snippets indicating substantive debate. The only potentially sensitive issue inherent in the bill is the continued imposition of per-bed assessments and surcharges on nursing facilities, which can affect facility finances, but the unanimous votes suggest that any concerns were not significant enough to produce recorded dissent. The bill’s extension of the Medicaid nursing facility program’s direct administration by the Medicaid Agency also appears to have been accepted without controversy.