Non-State Government-Owned Nursing Facility Upper Payment Limit Supplemental Payment Program, December 2016

(2016) Non-State Government-Owned Nursing Facility Upper Payment Limit Supplemental Payment Program, December 2016. Human Services, Department of (Health and Human Services, Department of)

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Abstract

Provisions of House File (HF) 2460 enacted by the 86th Iowa General Assembly, required the Department of Human Services (DHS) to submit to the Centers for Medicare and Medicaid Services (CMS) a Medicaid State Plan Amendment (SPA) to allow qualifying non-state government-owned (NSGO) nursing facilities (NF) to receive a supplemental payment in accordance with upper payment limit (UPL) requirements. The supplemental payment shall be in addition to the greater of the Medicaid fee-for-service per diem reimbursement rate or the per diem payment established for the NF under a Medicaid managed care contract. Provisions of HF 2460, enacted by the 86th Iowa General Assembly, required DHS to submit a report to the governor and the general assembly on or before December 15, annually after approval and implementation of the supplement payment program. At this time, approval by CMS has not been received and implementation processes have not begun. The content of this report is to supply an update on the directives of HF2460.