By Mr. Correia of Fall River, petition (accompanied by bill, House, No. 605) of Robert Correia and others relative to rates for residential care facilities.  Elder Affairs.

The Commonwealth of Massachusetts

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PETITION OF:

Robert Correia

Joyce A. Spiliotis

Christine E. Canavan

Stephen R. Canessa

Robert M. Koczera

Barbara A. L'Italien

Jennifer M. Callahan

Michael E. Festa

Thomas P. Conroy

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In the Year Two Thousand and Seven.

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An Act relative to rates for residential care facilities.

    Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

SECTION 1. Section 7 of Chapter 118G of the General Laws is hereby amended in the first paragraph by adding at the end thereof the following:

A public hearing on proposed rates for rest homes shall be held no later than August 15^th  of each year and rates for rest home shall be certified no later than September 1^st of each year. 

SECTION 2. Section 7 of Chapter 118G of the General Laws is hereby amended in the second paragraph by striking the following:

In setting such prospective or retrospective rates of reimbursement, the executive office shall use as base year costs for rate determination purposes the reported costs of the calendar year not more than four years prior to the current rate year, adjusted for reasonableness and to incorporate any audit findings applicable to said base year costs;

And replacing it with the following:

In setting such prospective or retrospective rates of reimbursement, the executive office shall use as base year costs for rate determination purposes the reported costs of the most recent calendar year available, which may not be more than two years prior to the current rate year, adjusted for reasonableness; provided further that the executive office appoint a committee to develop and recommend a methodology for establishing cost adjustment factors to project for the effect of inflation for every year after a base year period.  The committee shall consist of five independent consultants who are not otherwise employed by the commonwealth with experience in the field of health care economics.  At least one member of the committee shall be designated by the Massachusetts Aging Services Association and at least one member of the committee shall be designated by the Massachusetts Extended Care Federation.  

SECTION 3.  Section 7 of Chapter 118G of the General laws is hereby amended in the third paragraph by adding after the words “and other means to encourage the cost-efficient delivery of services” the following;

provided that the executive office shall not impose a negative total payment adjustment  to rates for rest homes which would have the effect of capping a provider’s rate increase. 

SECTION 4. Section 7 of Chapter 118G of the General laws is hereby amended in the fourth paragraph by striking the following:

Except for ceilings or maximum rates of reimbursement, which are determined in accordance with rate determination methods imposed on nursing homes, any ceiling or maximum imposed by the division upon the rate of reimbursement to be paid to rest homes shall reflect the actual costs of rest home providers and shall not prevent any such rest home provider from receiving full payment for costs necessarily incurred in the provision of services in compliance with federal or state regulations and requirements, or for costs incurred for direct care.

And replacing it with the following:

Except for ceilings or maximum rates of reimbursement, which are determined in accordance with rate determination methods imposed on nursing homes, any ceiling or maximum imposed by the division upon the rate of reimbursement to be paid to rest homes shall reflect the actual costs of rest home providers and shall not prevent any such rest home provider from receiving full payment for costs necessarily incurred in the provision of services in compliance with federal or state regulations and requirements, or for costs incurred for labor, energy, and insurance.