Governor Charles D. Baker's Budget Recommendation - House 1 Fiscal Year 2016

Outside Section 46



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Skilled Nursing Facility User Fee Waiver

SECTION 46.   Notwithstanding any general or special law to the contrary, the executive office of health and human services shall submit an application to the federal Centers for Medicare and Medicaid Services for a waiver of the provisions of 42 U.S.C. 1396b(w)(3)(B) and 42 U.S.C. 1396b(w)(3)(C) relative to the nursing facility user fee established by section 63 of chapter 118E of the general laws. The waiver application shall seek approval to amend the classes of nursing facilities subject to the user fee and the amount of user fee liability imposed on certain nursing facilities, as follows. Each nursing facility shall be classified into one of the following four classes: (I) nursing facilities that do not meet the criteria for class (II), (III) (or) (IV), herein; (II) non-profit continuing care retirement communities and non-profit residential care facilities; (III) non-profit facilities with total Medicaid days in excess of a threshold level of such days established by regulation promulgated by the executive office of health and human services; and (IV) facilities that have no more than 100 licensed beds, do not participate in the Medicare or Medicaid programs under titles XVIII and XIX of the federal social security act, and were established and licensed in Massachusetts prior to July 30, 1965. All facilities in class (I) shall be required to pay a user fee at the rate established by regulation promulgated by the secretary of health and human services in conformity with the total annual user fee revenue amount established by relevant provisions of any general or supplemental appropriation act and section 63 of chapter 118E of the general laws. Nursing facilities in classes (II) or (III) shall be required to pay a user fee at a rate equal to ten percent of the user fee rate imposed on nursing facilities in class (I). Nursing facilities in class (IV) shall be exempt from liability for the user fee established under section 63 of chapter 118E of the general laws and as modified pursuant to this section. The waiver application required by this section shall be structured in a manner that will qualify it for automatic approval by the federal Centers for Medicare and Medicaid Services pursuant to 42 CFR 433.68.
 
 

Summary:
This section requires MassHealth to propose a waiver program for the skilled nursing facility user fee in a manner that will automatically qualify for federal approval.



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