Bill Text: CT SB01025 | 2013 | General Assembly | Comm Sub

Connecticut Senate Bill 1025 (Prior Session Legislation)

Bill Title: An Act Concerning Advance Payments To Nursing Facilities For Uncompensated Care.

Spectrum: Committee Bill

Status: (Introduced - Dead) 2013-03-14 - Favorable Change of Reference, House to Committee on Appropriations [SB01025 Detail]

Download: Connecticut-2013-SB01025-Comm_Sub.html


General Assembly		*Raised Bill No. 1025*
*January Session, 2013*		LCO No. 3780
		_____SB01025HS_APP031313____
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)

AN ACT CONCERNING ADVANCE PAYMENTS TO NURSING FACILITIES FOR UNCOMPENSATED CARE.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Section 17b-340c of the general statutes is amended by adding subsection (c) as follows (Effective July 1, 2013):

(NEW) (c) Notwithstanding the provisions of subsections (a) and (b) of this section, the Commissioner of Social Services shall make an advance payment to a nursing facility, upon any such facility's request made not later than January 1, 2014, whenever the facility is providing uncompensated services to one or more residents (1) whose application for long-term medical assistance has been pending for more than ninety days, or (2) when payment has not been made to the facility within thirty days after the date such application has been approved. Any such advance payment shall not exceed fifty per cent of the estimated amount due. Not later than thirty days after any such application is granted and payment has been made to the facility, or after any such application has been denied, the commissioner shall recover advance payments made pursuant to this subsection by reducing any payments due to the facility.

Sec. 2. Section 17b-320 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):

(a) For purposes of this section and section 17b-321:

(1) "Commissioner" means the Commissioner of Revenue Services;

(2) "Department" means the Department of Revenue Services;

(3) "Nursing home" means any licensed chronic and convalescent nursing home or a rest home with nursing supervision, but does not include, upon approval of the waiver of federal requirements for uniform and broad-based user fees in accordance with 42 CFR 433.68, pursuant to section 17b-323, any nursing home that is owned and operated as of May 1, 2005, by the legal entity that is registered as a continuing care facility with the Department of Social Services in accordance with section 17b-521, regardless of whether such nursing home participates in the Medicaid program and any nursing home licensed after May 1, 2005, that is owned and operated by the legal entity that is registered as a continuing care facility with the Department of Social Services in accordance with section 17b-521;

(4) "Medicare day" means a day of nursing home care service provided to an individual who is eligible for payment, in full or with a coinsurance requirement, under the federal Medicare program, including fee for service and managed care coverage;

(5) "Resident day" means a day of nursing home care service provided to an individual and includes the day a resident is admitted and any day for which the nursing home is eligible for payment for reserving a resident's bed due to hospitalization or temporary leave and for the date of death. For purposes of this subdivision, a day of nursing home care service shall be the period of time between the census-taking hour in a nursing home on two successive calendar days. "Resident day" does not include a Medicare day or the day a resident is discharged;

(6) "Nursing home net revenue" means amounts billed by a nursing home for all room, board and ancillary services, minus (A) contractual allowances, (B) payer discounts, (C) charity care, and (D) bad debts; and

(7) "Contractual allowances" means the amount of discounts allowed by a nursing home to certain payers from amounts billed for room, board and ancillary services.

(b) (1) (A) For each calendar quarter commencing on or after July 1, 2005, there is hereby imposed a resident day user fee on each nursing home in this state, which fee shall be the product of the nursing home's total resident days during the calendar quarter multiplied by the user fee, as determined by the Commissioner of Social Services pursuant to subsection (a) of section 17b-321.

(B) Commencing with the calendar quarter in which approval of the waiver of federal requirements for uniform and broad-based user fees in accordance with 42 CFR 433.68 pursuant to section 17b-323 is granted, the resident day user fee shall be the product of the nursing home's total resident days during the calendar quarter multiplied by the user fee, as redetermined by the Commissioner of Social Services pursuant to subsection (b) of section 17b-321.

(2) Each nursing home shall, on or before the last day of January, April, July, and October of each year, render to the commissioner a return, on forms prescribed or furnished by the commissioner, stating the nursing home's total resident days during the calendar quarter ending on the last day of the preceding month and stating such other information as the commissioner deems necessary for the proper administration of this section. The resident day user fee imposed under this section shall be due and payable on the due date of such return, except that no such resident day user fee shall be due and payable if a nursing home is providing uncompensated services to one or more residents (A) whose application for long-term medical assistance has been pending for more than ninety days, or (B) when payment has not been made to the facility within thirty days from the date such application was approved. Each nursing home shall be required to file such return electronically with the department and to make such payment by electronic funds transfer in the manner provided by chapter 228g, irrespective of whether the nursing home would have otherwise been required to file such return electronically or to make such payment by electronic funds transfer under the provisions of said chapter 228g. Notwithstanding the provisions of this subdivision, the annual payment due date for the nursing home resident day user fee due and payable on or before (i) the last day of each January shall be extended to February fifteenth; (ii) the last day of each April shall be extended to May fifteenth; (iii) the last day of each July shall be extended to August fifteenth; and (iv) the last day of each October shall be extended to November fifteenth.

(c) Whenever such resident day user fee is not paid when due, a penalty of ten per cent of the amount due or fifty dollars, whichever is greater, shall be imposed, and interest at the rate of one per cent per month or fraction thereof shall accrue on such user fee from the due date of such user fee until the date of payment.

(d) The commissioner shall notify the Commissioner of Social Services of any amount delinquent under sections 17b-320 to 17b-323, inclusive, and, upon receipt of such notice, the Commissioner of Social Services shall deduct and withhold such amount from amounts otherwise payable by the Department of Social Services to the delinquent nursing home, except that no such deduction or withholding shall be made if a nursing home is providing uncompensated services to one or more residents (1) whose application for long-term care medical assistance has been pending for more than ninety days, or (2) when payment has not been made to the facility within thirty days from the date such application has been approved.

(e) The provisions of section 12-548, sections 12-550 to 12-554, inclusive, and section 12-555a shall apply to the provisions of this section in the same manner and with the same force and effect as if the language of said sections had been incorporated in full into this section and had expressly referred to the user fee imposed under this section, except to the extent that any provision is inconsistent with a provision in this section. For purposes of section 12-39g, the resident day user fee shall be treated as a tax.

(f) The commissioner may enter into an agreement with the Commissioner of Social Services delegating to the Commissioner of Social Services the authority to examine the records and returns of any nursing home subject to the resident day user fee imposed under this section and to determine whether such user fee has been underpaid or overpaid. If such authority is so delegated, examinations of such records and returns by the Department of Social Services and determinations by said department that such user fee has been underpaid or overpaid, shall have the same effect as similar examinations or determinations made by the Department of Revenue Services.

(g) (1) The commissioner shall not collect the resident day user fee pursuant to this section until the Commissioner of Social Services informs the commissioner that all the necessary federal approvals are in effect to secure federal financial participation matching funds associated with the rate increases as described in subdivision (4) of subsection (f) of section 17b-340.

(2) The commissioner shall cease to collect the resident day user fee pursuant to this section if the Commissioner of Social Services informs the commissioner that the federal approvals described in subdivision (1) of this subsection are withheld or withdrawn.

Sec. 3. (NEW) (Effective July 1, 2013) The Commissioner of Social Services shall reimburse a nursing facility in an amount up to the market rate interest incurred whenever (1) the facility is providing uncompensated services to residents whose application for long-term care medical assistance has been pending for more than ninety days, (2) the Department of Social Services is unable or fails to make payments owed to the facility for services rendered at scheduled times, and (3) the nursing facility has borrowed from a lender to provide such services to the resident or to cover the untimely payments.


This act shall take effect as follows and shall amend the following sections:
Section 1	July 1, 2013	17b-340c
Sec. 2	July 1, 2013	17b-320
Sec. 3	July 1, 2013	New section