Administrative Rule Review Report  #AR12-015

Legislative Service Office

02-Apr-12

AGENCY: Department of Health

DATE SUBMITTED:                      3/20/2012

SUBJECT: Chapter 7, Nursing Home Reimbursement System; Chapter 17, Nursing Facility Residence Trust; Chapter 19, Nursing Facility Preadmission Screenings; Chapter 23, Costs incurred by NH in Implementing the OBRA/87 Requirements (repealed); Chapter 28, Swingbed Services

NATURE OF RULES:                     Legislative and procedural.

STATUTORY AUTHORITY:         W.S. 42-4-104(a)(iv).

DETERMINATION OF PROCEDURAL COMPLIANCE BASED UPON INFORMATION SUBMITTED BY THE AGENCY TO LSO:                  Apparently complete to date.  Notice of the proposed adoption of new rules was provided by the LSO as required by W.S. 28-9-103(d). No comments have been received to date.

SUMMARY OF RULES:      These amendments generally revise the Department of Health's Medicaid rules.  Significant changes include:

· Revision of all chapters' definitions and overpayment recovery procedures, in accord with provisions previously adopted for all Medicaid rules chapters (ARR11-43, 8/29/2011);

· Revised nursing facility cost reporting dates and a new effective date for nursing home  rate setting;

· Repeal of obsolete provisions regarding rate add-ons;

· Clarification of pre-admission screening requirements, reserved bed days and cost disallowances;

· Replacement of the phrase "mentally retarded" with "intellectual disability";

· Clarification of the requirement for and timing of a pre-admission screening resident review ("PASRR") for recipients of swing-bed services.

FINDINGS:  The rules appear to be within the scope of statutory authority and legislative intent.

STAFF RECOMMENDATION:  That the rules be placed on the Consent List and be approved by the Council as submitted by the Agency.

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Gerald W. Laska

Staff Attorney

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Mark Quiner

Assistant Director