SS. Tax 11.09 & 11.28. - Medicines and to gifts and other advertising specialties.
Summary of Final Regulatory Flexibility Analysis:
The proposed rule order does not have a significant economic impact on a substantial number of small businesses.
Summary of Comments:
No comments were reported.
19.
Social Workers, Marriage and Family Therapists and Professional Counselors
(CR 98-53)
Chs. SFC 1 & 8 - Continuing education requirements for renewal of social worker certificates.
Summary of Final Regulatory Flexibility Analysis:
The proposed rule order does not have a significant economic impact on a substantial number of small businesses.
Summary of Comments:
No comments were reported.
Ch. Trans 31 - Excursion Permits on State-Owned Rail Lines.
Summary of Final Regulatory Flexibility Analysis:
The rules will have an adverse effect on a limited number of small businesses. these businesses will be required to modify or operate equipment used to provide excursion trips so that human waste is not discharged onto the rail corridor. The rule will increase the application and inspection fee for a permit.
Summary of Comments:
No comments were reported.
S. VA 1.10 (7) - Release of information to a collection agency under contract with the state to collect delinquent Department loans.
Summary of Final Regulatory Flexibility Analysis:
This rule is not expected to have an adverse impact on small businesses.
Summary of Comments:
No comments were reported.
S. VA 1.19 - Cancellation of indebtedness under the economic assistance, veterans trust fund stabilization, personal and secondary loan programs.
Summary of Final Regulatory Flexibility Analysis:
This rule is not expected to have an adverse impact on small businesses.
Summary of Comments:
No comments were reported.
23.
Workforce Development
(CR 99-6)
S. DWD 290.155 - Annual adjustment of the minimum estimated project costs for the application of the requirement to obtain a determination of prevailing wage rates for workers employed on state or local public works projects.
Summary of Final Regulatory Flexibility Analysis:
The proposed rule does not affect small business.
Summary of Comments:
No comments were reported.
E x e c u t i v e O r d e r s
The following is a listing of recent Executive Orders issued by the Governor.
Executive Order 368. Relating to a Proclamation that the Flag of the United States and the Flag of the State of Wisconsin be flown at half-staff as a mark of respect for the late John Tomlin.
Executive Order 369. Relating to a Proclamation that the Flag of the United States and the Flag of the State of Wisconsin be Flown at Half-Staff as a Mark of Respect for Peace Officers Who Have Given Their Lives in the Line of Duty.
Public Notice
Public Notice
Health and Family Services
(Medical Assistance Reimbursement of Nursing Homes:
State of Wisconsin Medicaid Nursing Facility Payment Plan for FY 1999-2000)
The State of Wisconsin reimburses Medicaid-certified nursing facilities for long-term care and health care services provided to eligible persons under the authority of Title XIX of the Federal Social Security Act and ss. 49.43 to 49.497, Wisconsin Statutes. This program, administered by the State's Department of Health and Family Services, is called Medical Assistance (MA) or Medicaid. Federal statutes and regulations require that a state plan be developed that provides the methods and standards for setting payment rates for nursing facility services covered by the payment system. A plan that describes the nursing home reimbursement system for Wisconsin is now in effect, as approved by the federal Health Care Financing Administration (HCFA).
The Department is proposing changes in the methods of payment to nursing homes and, therefore, in the plan describing the nursing home reimbursement system. The changes are effective July 1, 1999.
The proposed changes would update the payment system and make various payment-related policy changes. Some of the changes are necessary to implement policies contained in the Wisconsin 1999-2001 Biennial Budget. Some of the changes are technical. Some others clarify various payment plan provisions.
The estimated increase in annual aggregate expenditures attributable to these changes for nursing homes serving MA recipients is approximately $20,000,000, all funds including increases in patient liability, ($15,000,000 FFP/GPR).
The proposed changes will implement expected changes in Wisconsin Statutes governing Medicaid payment systems, in particular affecting s. 49.45 (6m), Wis. Stats.
Summary of Proposed Changes:
The proposed changes are as follows:
1. Modify the methodology to adjust the reimbursement for nursing homes within the parameters of the 1999-2001 Biennial Budget Bill, and to disburse the $20,000,000 allotted in the bill to pay for a 1.8% rate increase. These modifications will include adjustments to the medians used to calculate maximums and per diem increases in Sections 5.400, 5.500 and 5.600, changes in the occupancy percentage used to establish the minimum occupancy standard in Section 3.030, the inflation and deflation factors in Section 5.300, and targets in Sections 3.000 and 5.000. The over-the-counter drug parameter in Section 5.900 will be updated. The parameters for calculating the capital payment will be updated and moved from Section 3.530 to Section 5.000.
2. Reconfigure the direct care calculation in Section 3.100 to allow for a calculation of direct care maximums applying a case mix index adjustment to the present levels of care.
3. Start to phase in a new labor region index based on a different set of variables than the old system. Labor regions are used in calculating the direct care maximums.
4. Establish an incentive payment for homes with high Medicaid utilization and an atypically high number of private rooms.
5. Amend Section 3.526 (e) to allow Continuing Care Retirement Centers' actuaries to calculate the amount of reserves needed to offset lifetime contracts, if the contract language does not mandate that residents apply for Medicaid when the residents' funds are exhausted.
6. Amend Section 1.173 to include delinquent occupied bed assessment as grounds for withholding Medicaid payment.
7. Amend Section 3.062 to state that if banked beds are a part of a phase-down, those beds are expunged from the bed bank.
8. Create in Section 1.300 a definition of cost report stating that the 1997 cost report will be used to calculate the direct care, support, fuel and utilities components of the rate and the 1998 cost report will be used to calculate the property component, property tax and municipal service fees, and for IGT calculations. Exceptions to this may be for facilities in a start-up or phase-down period per Sections 4.300, 4.400, 4.500 and 4.600 as mentioned in Section 1.302.
9. Amend Section 3.532 to clarify how to apply the 40% cost share.
10. Change the date used to calculate the lease maximum in Section 3.523 to 1998-1999.
11. Clarify that Section 3.732 (6) refers to Section 3.600, over-the-counter drugs.
12. Amend Section 3.062 to provide that banking beds will only affect rates set for the following rate year.
13. Amend Section 3.520 to more clearly express the policy intended.
14. Amend Section 4.697 to state that the contractor will be paid only after the Department of Health and Family Services has approved the appraisal.
15. Amend Sections 3.030, 3.070, 3.126 (a) and 3.532 to limit the 50-bed facility exclusion to only facilities not associated with hospitals.
16. Create a definition in section 1.300 of facilities associated with hospitals.
17. Establish a payment rate for residents with traumatic brain injury who require special services but do not meet the criteria for admission to a special unit approved under Section 4.692.
18. Amend Section 4.320 to increase the minimum occupancy standard for new facilities.
19. Amend Section 4.433 to refer to Section 3.722, item 3.
20. Move Section 7.300 to Section 1.000.
21. Delete Section 7.000.
22. Amend Sections 3.534 and 3.010 to modify the 91% occupancy rate.
23. Add items to Sections 5.140, 5.150 and 5.160.
24. Create in Section 1.300 a definition of licensed beds as of June 30, 1999.
25. Amend Section 1.550 to clarify that no covered, but unreimbursed, services may be charged to a resident or a third party during therapeutic visits.
Copies of the Proposed Changes:
Copies of the available proposed changes and proposed rates may be obtained free of charge by writing to:
Division of Health Care Financing
Attention: Nursing Home Medicaid Payment Plan
