Changes to nursing facility Value-Based Reimbursement statute 2022 Regular Session HF4065 Chapter 98, Article 7, Sections 8–30 Health & Human Services omnibus policy bill Effective: August 1, 2022 Short description A number of policy changes were made to the statutes governing the Medicaid nursing facility reimbursement system known as Value-Based Reimbursement (VBR). Summary After an unsuccessful attempt to modify Minnesota Statute 256R during the 2021 Legislative Session, the Minnesota Department of Human Services (DHS) was successful in 2022. In most cases, the new statutory language makes changes that conform statute to current practice. Here is a non-exhaustive summary: • Section 8 modifies the definition of administrative costs to include purchasing and inventory employees and modify advertising to “nonpromotional advertising” • Section 9 modifies direct care costs by clarifying that supplemental nursing agency costs are limited by the maximum allowable charges minus any lodging or travel costs • Section 10 modifies the employee health insurance costs definition—two changes are made: o First, actual expenses incurred for self-insured plans is re-worded to include actual claims paid, stop-loss premiums, and plan fees; actual expenses incurred for selfinsured plans does not include allowances for future funding unless the plan meets the Medicare requirements for reporting on a premium basis when the Medicare regulations define the actual costs o Second, employer contributions to employer-sponsored individual coverage health reimbursement arrangements as provided by Code of Federal Regulations, title 45, section 146.123 are allowed • Section 23 adds language permitting employer contributions to employer sponsored individual coverage health reimbursement arrangements if the provider reports specific documents and information • Section 12 modifies maintenance and plant operations costs to include 1) plastic waste bags (removed from direct care costs), and 2) minor equipment not requiring capitalization under Medicare guidelines • Section 13 defines minor equipment to mean equipment that does not qualify as either fixed equipment or depreciable movable equipment as defined in section 256R.261 • Section 15 modifies the definition of special assessment by clarifying that they are not voluntary costs and are not recognized as a pass-through cost if they are included in the property rate • Section 16 defines “vested” to mean the existence of a legally fixed unconditional right to a present or future benefit • Section 17 modifies nursing facility documentation requirements include signed and dated position descriptions • Section 18 modifies the documentation of compensation requirements by deleting language and replacing with language stating that salary allocations are allowable using the Medicareapproved allocation basis and methodology only if the salary costs cannot be directly determined, including when employees provide shared services to noncovered operations • Section 19 updates the adequate documentation supporting nursing facility payrolls to address changes in storage • Section 20 adds language to the reporting of financial statements stating that the data, notes, and preliminary drafts of reports created, collected, and maintained by the audit offices of government entities, or persons performing audits for government entities, and relating to an
CARE PROVIDERS OF MINNESOTA
-33-
2022 LEGISLATIVE UPDATE BOOK
