98RS HB785


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HB 785/FN (BR 2675) - S. Nunn

     AN ACT relating to the medical assistance program.
     Amend KRS 205.640 to change the MAIT fund balances from $81 million dollars to $93 million dollars in FY '98 and from $86 million dollars to $94 million dollars in each year of the biennium for FY '99-2000; increase the eligibility for Medicaid beneficiaries who would be eligible for covered services in a hospital setting; from 100% of poverty level to 150% of the federal poverty level; require that MAIT funds be based on both hospital inpatient and outpatient services; allow individual hospitals to receive distributions from the MAIT fund for indigent care; require that the Department for Medicaid Services reimburse hospital's at the hospital's Medicaid rate, which means the cost of providing indigent care services is determined by applying each hospital's cost to charge ratio to allowable indigent charges and require that the Department for Medicaid Services calculate the cost to charge ratio for each hospital by dividing the hospital's total allowable operating expenses by the hospital's gross patient charges; create a new section of KRS 205 to outline an enhanced Medicaid payment for county owned or operated hospitals, using cost reports and implementing an intergovernmental transfer program for county owned or operated hospitals; allow for other hospital shortfalls to be reimbursed from any surplus from the MAIT fund; require the cabinet to promulgate administrative regulations to implement these provisions.


     HCS/FN - Delete provision in KRS 205.640 subsection (5)(a) which sets aside funds from the MAIT fund for use in compensating hospitals that do not qualify for the disproportionate share program for hospitals; delete the requirement that the fund reimburse both inpatient and outpatient services and require the existing term of paying for services to remain; change the dates when the Department for Medicaid Services calculates the payment due from April 1 to June 1 of each year to now be from July 1 to August 1; require that the cost reports from hospitals be filed as of June 30 of each year instead of April 1; require that payments to hospitals be made no later than August 15; require that all enhanced payments be based on cost reports filed on June 30 of each year and that any intergovernmental transfer made to the enhanced Medicaid payment fund be made by August 2 of each fiscal year.
     HCA (1, S. Nunn) - Require that when disbursing funds to provide disproportionate share hospital payments to qualified hospitals, funds shall first be proportionately reduced for all hospitals with over 200 beds. If the total amount still exceeds funds available, then hospitals with fewer than 200 beds shall be proportionately reduced.
     HFA (1, S. Nunn) - Amend to limit the rate of Medicaid payment to hospitals with less than 200 licensed acute care beds; require that subsection (1) not be implemented as part of the disproportionate share hospital program.
     SCA (1, G. Neal) - Establish a Medicaid Managed Care Oversight Advisory Committee, comprised of 5 Senate members appointed by the Senate President and 5 House of Representatives members appointed by the Speaker of the House; direct that the Committee meet at least four times annually and provide oversight on the implementation of Medicaid Managed Care within the Commonwealth, including access to services, utilization of services, quality of services, and cost containment.

     Mar 2-introduced in House
     Mar 3-to Health and Welfare (H)
     Mar 9-posted in committee; posting waived
     Mar 10-reported favorably, 1st reading, to Calendar with Committee Substitute and Committee Amendment (1)
     Mar 11-2nd reading, to Rules
     Mar 12-floor amendment (1) filed to Committee Substitute; posted for passage in the Regular Orders of the Day for March 13, 1998
     Mar 16-3rd reading, passed 94-0 with Committee Substitute and floor amendment (1)
     Mar 17-received in Senate
     Mar 18-to Health and Welfare (S)
     Mar 20-reported favorably, 1st reading, to Consent Calendar with committee amendment (1)
     Mar 23-2nd reading, to Rules
     Mar 24-posted for passage in the Consent Orders of the Day for March 25, 1998
     Mar 25-3rd reading, passed 37-0 with committee amendment (1)
     Mar 26-received in House; posted for passage for concurrence in Senate amendment
     Mar 31-House concurred in Senate committee amendment (1); passed 94-0
     Apr 1-enrolled, signed by each presiding officer, delivered to Governor
     Apr 13-signed by Governor

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