LRB-0243/2
TJD:jld:rs
2011 - 2012 LEGISLATURE
DOA:......Dombrowski, BB0084 - Update resource utilization grouping terminology
For 2011-13 Budget -- Not Ready For Introduction
An Act ...; relating to: the budget.
Analysis by the Legislative Reference Bureau
health and human services
Medical Assistance
Currently, the federal Centers for Medicare and Medicaid Services (CMS) oversees the Medical Assistance (MA) program, which is administered in this state by DHS. MA provides benefits to eligible individuals who reside in a nursing home or a certain licensed community-based residential facility. CMS currently uses a method, called "Resource Utilization Groupings III," to categorize residents of facilities by the level of needed resources. These categories are used to calculate the payments to facilities under MA. This acuity-based payment system currently requires the incorporation of acuity measurements under the most recent "Resource Utilization Groupings III" methodology to set the case-mix adjustment. This bill changes the terminology to "Resource Utilization Groupings" and allows, instead of requires, the incorporation of acuity measurements for case-mix adjustment.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
Section
1. 49.45 (6m) (a) 6. of the statutes is amended to read:
49.45 (6m) (a) 6. "Resource Utilization Groupings
III" means a comparative resource utilization grouping that classifies each facility resident based on information obtained from performing, for the resident, a minimum data set assessment developed by the federal Centers for Medicare and Medicaid Services.
Section
2. 49.45 (6m) (ag) 3p. a. of the statutes is amended to read:
49.45 (6m) (ag) 3p. a. The system shall may incorporate acuity measurements under the most recent Resource Utilization Groupings III methodology to determine factors for case-mix adjustment.
(End)
