Lt. Gov. Dianne Primavera signed the bipartisan HB23-1228 which authorizes the Department of Health Care Policy & Financing to move nursing facility reimbursement rate methodology out of state statute and into regulation over the next three years.
During the COVID-19 pandemic and subsequent labor market changes, the inflexible nature of the nursing facility statute inhibited HCPF’s ability to adjust to changes in market dynamics and operational costs for nursing facilities. The updated rulemaking process will provide both the industry and HCPF more opportunity to fully discuss what may be needed and adjust reimbursement rates to meet those identified needs.
HB23-1228 not only improves nursing facility reimbursement rates, but also incentivizes access to care for Coloradans with the most complex needs, while increasing quality outcomes and financial transparency in the industry. The industry has seen a massive shift in its business models as a result of the pandemic. By moving the methodology to regulation, HCPF will also be able to monitor and adjust rural rates should the Medicaid utilization payment not fully address their needs.
“This bill is the culmination of over seven years of hard work with the industry and stakeholders which represents momentous steps towards innovation, transparency, and industry stabilization,” said Division Director Bonnie Silva, Office of Community Living at HCPF. “We thank the industry for their support in moving this forward.”
The bill also includes meaningful measures towards establishing transparency in ownership and funding through the collection of audited financial statements and disclosure of shared ownership. These reporting mechanisms will allow HCPF to better track how Medicaid funds are being used and ensure funds are not being simply passed along to related entities. It also provides opportunities for ongoing stakeholder input into the regulatory development process over the next three years to ensure Colorado will have a nursing facility reimbursement model that works.
