MM Curator summary
[MM Curator Summary]: More details on the plan to increase nursing home facility pay and continue the underlying provider “tax” mechanism used to pay for it all. Punchline- meet 70% of CMS staffing guidelines and get bonuses.
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
Gov. J.B. Pritzker (D)
A $700 million Medicaid funding boost is coming to Illinois providers after Gov. J.B. Pritzker (D) on Tuesday signed nursing home reform legislation that ties the Medicaid increases to higher staffing levels.
The legislation was specifically highlighted by top leaders at the Centers for Medicare & Medicaid Services earlier this year as it looks to better support states and implement new payment frameworks for providers.
The measure was originally passed in April before being signed into law this week. Under the law, Illinois will increase its $2.5 billion in annual nursing home funding by roughly $700 million, with $100 million coming from the state and the rest from federal Medicaid and provider assessments.
It also calls on nursing homes to meet at least 70% of federal staffing level guidelines in order to qualify for bonus reimbursements. Nursing homes’ star ratings also will be taken into consideration for reimbursement increases.
Providers and resident advocates both have hailed the reform measure.
“Everyone deserves quality affordable healthcare,” Pritzker said Tuesday. “With [the] signing, Illinois will no longer tolerate an emphasis on profits over people, especially at the expense of our most vulnerable seniors.”
CMS Administrator Chiquita Brooks-LaSure in April said CMS is “moving in an additional direction to make sure the dollars that are being spent are going to direct care.”
New York also has pushed ahead with legislation that ties funding to direct care at nursing homes. The state in February passed legislation that requires providers to spend a minimum of 70% of revenue on direct care — with at least 40% of that going to direct care workers.