Ch. HFS 75 - Relating to community substance abuse service standards.
Ch. Tax 14 - Relating to homestead credit administrative provisions; qualification for credit; household income and income; property taxes accrued; gross rent and rent constituting property taxes accrued; and marriage, separation or divorce during a claim year.
SS. VA 2.01 and 12.02 and ch. VA 15 - Relating to the health care aid grant program, to the personal loan program, and to federally-recognized American Indian tribes and bands.
Administrative Rules Filed With The
Revisor Of Statutes Bureau
The following administrative rules have been filed with the Revisor of Statutes Bureau and are in the process of being published. The date assigned to each rule is the projected effective date. It is possible that the publication of these rules could be delayed. Contact the Revisor of Statutes Bureau at (608) 266-7275 for updated information on the effective dates for the listed rules.
An order affecting ss. Comm 32.24, 32.33 and 32.50, relating to public employe safety and health.
An order affecting ch. DOC 309, relating to inmate visitation.
An order creating ch. El Bd 7, relating to approval of electronic voting equipment.
An order creating s. ETF 10.55, relating to the proper reporting of creditable service, earnings and participating employes of instrumentalities of two or more units of government when the joint instrumentality does not qualify as a separate employer for Wisconsin Retirement System (WRS) purposes.
Financial Institutions--Securities (CR 00-17):
An order amending s. DFI-Sec 5.01 (4) (b) and (e), relating to investment adviser representative competency examination grandfathering provisions.
An order amending ss. Psy 2.08 and 3.10, relating to reexaminations.
An order repealing and recreating ch. PSC 111, relating to the replacement of advance plans with strategic energy assessments (SEA's) and revision of requirements for Certificates of Public Convenience and Necessity (CPCN's).
An order affecting ch. PSC 4, relating to implementing the Wisconsin Environmental Policy Act (WEPA), concerning the environmental analysis (EA) procedures for proposed actions before the Public Service Commission.
Dept. of Health and Family Services
(Medical Assistance Reimbursement of Nursing Homes)
State of Wisconsin Medicaid Nursing Facility Payment Plan: FY 00-01
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 49.47, Wisconsin Statutes. This program, administered by the Department of Health and Family Services, is called Medical Assistance 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, 2000.
The proposed changes would update the payment system and make various payment-related policy changes. Some of the changes are necessary to implement various budget policies contained in the Wisconsin 1999-2001 Biennial Budget. Some of the changes are technical in nature; some clarify various payment plan provisions.
The estimated increase in annual aggregate expenditures attributable to these changes for nursing homes serving Medicaid residents is approximately $17,170,800 all funds, ($10,302,480 FFP), excluding patient liability.
The proposed changes are being implemented to comply with Wisconsin Statutes governing Medicaid payment systems, particularly s. 49.45 (6m), Wis. Stats.
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 $17,170,800 allotted in the bill to a rate increase of 2%. 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 Sections 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 moved from Section 3.530 to Section 5.000 and will be updated. Changing references to 1999-2000, 1999, 2000 to 2000-2001, 2000, 2001 for descriptive reasons will be done where necessary.
2. Continue 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.
3. Establish in Section 3.750 an incentive payment for homes with high Medicaid utilization and an atypically high number of private rooms.
4. Change Section 1.300 to state that the 1999 cost report will be used to calculate the rate. 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.
5. Change the dates of the definitions of base cost reporting period, common period, and rate payment year in Sections 1.302, 1.303, and 1.314 to reflect the 2000-2001 period.
6. Change the deadline for bed banking in Section 3.060 to June 30, 2000.
7. In Section 3.126 (a), change Adjustment to Maximum to Adjustment to Case Mix, allowing the case mix index for facilities with fifty beds or less for rate setting to have a 20% increase on their case mix index.
8. Create Section 3.790 to allow the Department to pay the Medicaid portion of the cost to facilities that contract for relocation services when the Department has ordered a relocation plan.
State in Section 3.500 that donated homes shall be valued at the lesser of fair market or net book value of the last owner.
10. Amend Sections 3.221, 3.253, 3.350, 3.430, 3.534 and 3.610 and to state that, if a facility's occupancy is below the minimum occupancy factor, allowable cost will be the projected cost divided by adjusted patients days times minimum occupancy factor.
11. Change the last sentence in Section 2.253 so that documented management costs may be substituted for reported costs, subject to allowability.
12. Move the definition of minimum occupancy from Section 3.030 to Section 1.317 and change all references to Section 3.030 accordingly.
13. Exclude boilers, air conditioners, condensers and windows from the energy incentive for projects approved or started after July 1, 2000.
14. State in Section 2.220 that residents are not to be charged for laundering of gowns.
15. Change wording in Section 3.523(2) to clarify the determination of lease maximums.
16. Amend Section 3.050 to add a subsection (4) stating that if a facility qualifies a rate adjustment under Section 4.800, licensed beds will be adjusted.
17. Amend eligibility standards under Section 4.800.
18. Change Section 3.040 to state that if a facility's fiscal year end falls between January 1, 2000 and June 30, 2000, its number of beds for rate setting will be the beds for rate used for the July 1, 1999, rate plus beds returned to the license from the bed bank but minus any bed bank deposit made through June 30, 2000. If a facility's fiscal year end falls on or after July 1, 2000, its bed for rate setting will be its licensed bed number at the end of its cost reporting period minus its bed bank balance.
19. Create Section 3.750 and move Sections 3.254 and 3.320 there.
20. Change section 1.800 to indicate that all administrative reviews should be sent to David Lund.
21. Adjust the base allowance, the qualifying Medicaid percentage and the calculation method for the exceptional Medicaid utilization adjustment in Section 3.750.
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
Attn: Nursing Home Medicaid Payment Plan
P.O. Box 309
Madison, WI 53701-0309
or by faxing:
James Cobb at (608) 264-7720
The available proposed changes may be reviewed at the main office at any county department of social services or human services.
Written comments on the proposed changes may be sent to the Division of Health Care Financing, at the above address. The comments will be available for public review between the hours of 7:45 a.m. and 4:30 p.m. daily in Room 355 of the State Office Building, 1 West Wilson Street, Madison, Wisconsin. Revisions may be made in the proposed changes based on comments received. There will also be public meetings to seek input on the proposed plan amendment. If you would like to be sent a public meeting notice, please write to the above address. Revisions may also be made in the proposed changes based on comments received at these forums.