Supplemental payments to hospitals with avoidable patient days and an enhanced rate to nursing homes for bariatric and extensive wound care under the Medical Assistance program. (FE)
Impact
The financial implications of AB1087 extend to nursing homes as well, as it mandates the development of an enhanced reimbursement rate specifically for patients with bariatric and extensive wound care needs. This adjustment to nursing home reimbursement rates aims to address the unique health care requirements of these residents, recognizing the additional costs associated with such care needs. The bill ensures that nursing homes can seek reimbursement for various expenses linked to these enhanced care requirements, which aligns with the intentions of improving care outcomes and financial sustainability for care facilities.
Summary
Assembly Bill 1087 is aimed at enhancing financial support to hospitals and nursing homes under the Medical Assistance program. The bill stipulates that the Department of Health Services (DHS) will provide supplemental payments to hospitals facing avoidable patient days, which are defined as days a high-acuity patient remains hospitalized despite being eligible for discharge, generally occurring after the seventh consecutive day of needing such care. Each quarter, starting July 1, 2024, the DHS is required to distribute a total of $5 million, alongside any federal matching funds, to hospitals based on their share of these qualifying avoidable patient days.
Contention
Notably, AB1087 establishes parameters for lead funding with a cap of $10 million for the enhanced reimbursement rates for nursing homes. Additionally, it specifies that nursing homes may only claim one type of enhanced rate per resident, preventing double funding for patients with both bariatric and wound care needs. This restriction has been a point of discussion among health care advocates, who argue that it may limit necessary funding and support for complex patient needs while emphasizing the importance of careful implementation to ensure that hospitals and nursing homes are adequately supported.
Direct payments for Medical Assistance, Medical Assistance reimbursement rates, care coordination services under the Medical Assistance program, grants for community primary care and outreach, and making an appropriation. (FE)
Reimbursement for doula services under the Medical Assistance program, doulas accompanying Medical Assistance recipients in hospitals and birthing centers, and granting rule-making authority. (FE)
Reimbursement for doula services under the Medical Assistance program, doulas accompanying Medical Assistance recipients in hospitals and birthing centers, and granting rule-making authority. (FE)
A bill for an act relating to the supplemental nutrition assistance program; the medical assistance program; the special supplemental nutrition program for women, infants, and children; and other public assistance programs under the purview of the department of health and human services. (Formerly HSB 696.)
A bill for an act relating to the supplemental nutrition assistance program, the medical assistance program, and other public assistance programs under the purview of the department of health and human services.(See HF 2716.)