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Montana Administrative Register Notice 37-735 No. 23   12/10/2015    
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BEFORE THE DEPARTMENT OF PUBLIC

HEALTH AND HUMAN SERVICES

OF THE STATE OF MONTANA

 

In the matter of the amendment of ARM 37.40.422 pertaining to updating direct care wage effective dates and reimbursement updates effective January 1, 2016

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NOTICE OF PROPOSED AMENDMENT

 

NO PUBLIC HEARING CONTEMPLATED

 

TO: All Concerned Persons

 

1. On January 11, 2016, the Department of Public Health and Human Services proposes to amend the above-stated rule.

 

2. The Department of Public Health and Human Services will make reasonable accommodations for persons with disabilities who wish to participate in this rulemaking process or need an alternative accessible format of this notice. If you require an accommodation, contact the Department of Public Health and Human Services no later than 5:00 p.m. on January 4, 2016, to advise us of the nature of the accommodation that you need. Please contact Kenneth Mordan, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena MT 59604-4210; telephone (406) 444-4094; fax (406) 444-9744; or e-mail dphhslegal@mt.gov.

 

3. The rule as proposed to be amended provides as follows, new matter underlined, deleted matter interlined:

 

37.40.422  DIRECT CARE AND ANCILLARY SERVICES WORKERS' WAGE REPORTING/ADDITIONAL PAYMENTS INCLUDING LUMP SUM PAYMENTS FOR DIRECT CARE AND ANCILLARY SERVICES WORKERS' WAGE AND BENEFIT INCREASES (1) Effective for the period January 1, 2015 January 1, 2016 through December 31, 2015 December 31, 2016, swing-bed hospitals must report to the department actual hourly wage and benefit rates paid for all direct care and ancillary services workers or the lump sum amounts paid for all direct care and ancillary services workers that will receive the benefit of a direct care and ancillary workers' wage and benefit increase.

(2) remains the same.

(3) The department will pay Medicaid certified swing-bed hospitals located in Montana, in accordance with this rule, lump sum payments in addition to the reimbursement rate to be used only for wage and benefit increases or lump sum payments for direct care or ancillary services workers in swing-bed hospitals.

(a) The department will determine lump sum payments January 1, 2015 January 1, 2016, and again six months from that date as a pro rata share of appropriated funds allocated for increases in direct care and ancillary services workers' wages and benefits or lump sum payments to direct care and ancillary services workers.

(b) through (4) remain the same.

 

AUTH: 53-2-201, 53-6-113, MCA

IMP:     53-2-201, 53-6-101, 53-6-111, MCA

 

          4. STATEMENT OF REASONABLE NECESSITY

 

The Department of Public Health and Human Services (department) is proposing amendments to ARM 37.40.422.

 

ARM 37.40.422

 

The proposed amendment to (1) is necessary to update fiscal year 2015 to fiscal year 2016 as the time frame for incorporation of funding for swing-bed direct care wages.

 

The proposed amendment to (3)(a) is necessary to update January 1, 2015 to January 1, 2016 as the beginning time frame for incorporation of funding for Medicaid direct care wage payments for swing-bed providers.

 

Fiscal Impact

 

The department is continuing the methodology for Medicaid swing beds that incorporates the calendar year average nursing facility payment rate calculation. There are 45 hospital/critical access hospital (CAH) swing-bed providers participating in Medicaid that will be impacted by these changes. Thirteen of the providers will participate in the fiscal year (FY) 2016 direct care wage funding in the amount of $227,774. This includes the original funding and new funding adopted for wages in the 64th session of the Montana Legislature.

 

The change in funding will implement an approximate 2 percent increase in Medicaid swing-bed provider rates. The total state and federal funds that will be allocated to swing-bed providers in calendar year 2016 is approximately $6,923,840 inclusive of the provider rate increase and supplemental direct care wage funding. The projected Medicaid swing-bed rate will increase from an average of $167.67 to $171.01 inclusive of the direct care wages payment. For providers that do not participate in the direct care wage funding the calendar year average rate will increase from $163.42 to $166.75.

 

5. The department intends to apply this rule amendment retroactively to January 1, 2016. A retroactive application of the proposed rule amendment does not result in a negative impact to any affected party.

 

6. Concerned persons may submit their data, views, or arguments concerning the proposed action in writing to: Kenneth Mordan, Office of Legal Affairs, Department of Public Health and Human Services, P.O. Box 4210, Helena MT 59604-4210, no later than 5:00 p.m. on January 11, 2016. Comments may also be faxed to (406) 444-9744 or e-mailed to dphhslegal@mt.gov.

 

7. If persons who are directly affected by the proposed action wish to express their data, views, or arguments orally or in writing at a public hearing, they must make written request for a hearing and submit this request along with any written comments to Kenneth Mordan at the above address no later than 5:00 p.m., January 11, 2016.

 

8. If the agency receives requests for a public hearing on the proposed action from either 10 percent or 25, whichever is less, of the persons directly affected by the proposed action; from the appropriate administrative rule review committee of the Legislature; from a governmental subdivision or agency; or from an association having not less than 25 members who will be directly affected, a hearing will be held at a later date. Notice of the hearing will be published in the Montana Administrative Register. Ten percent of those directly affected has been determined to be 4.5 persons based on forty-five hospital/critical access hospital (CAH) swing-bed providers.

 

9. The department maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency.  Persons who wish to have their name added to the list shall make a written request that includes the name, e-mail, and mailing address of the person to receive notices and specifies for which program the person wishes to receive notices. Notices will be sent by e-mail unless a mailing preference is noted in the request. Such written request may be mailed or delivered to the contact person in 6 above or may be made by completing a request form at any rules hearing held by the department.

 

10. An electronic copy of this proposal notice is available through the Secretary of State's web site at http://sos.mt.gov/ARM/Register. The Secretary of State strives to make the electronic copy of this notice conform to the official version of the notice, as printed in the Montana Administrative Register, but advises all concerned persons that in the event of a discrepancy between the official printed text of the notice and the electronic version of the notice, only the official printed text will be considered. In addition, although the Secretary of State works to keep its web site accessible at all times, concerned persons should be aware that the web site may be unavailable during some periods, due to system maintenance or technical problems.

 

11. The bill sponsor contact requirements of 2-4-302, MCA, do not apply.

 

12. With regard to the requirements of 2-4-111, MCA, the department has determined that the amendment of the above-referenced rule will not significantly and directly impact small businesses.

 

13. Section 53-6-196, MCA, requires that the department, when adopting by rule proposed changes in the delivery of services funded with Medicaid monies, make a determination of whether the principal reasons and rationale for the rule can be assessed by performance-based measures and, if the requirement is applicable, the method of such measurement. The statute provides that the requirement is not applicable if the rule is for the implementation of rate increases or of federal law.

 

The department has determined that the proposed program changes presented in this notice are not appropriate for performance-based measurement and therefore are not subject to the performance-based measures requirement of 53-6-196, MCA.

 

 

 

/s/ Valerie A. Bashor                              /s/ Mary E. Dalton acting for                 

Valerie A. Bashor                                  Richard H. Opper, Director

Rule Reviewer                                       Public Health and Human Services

 

Certified to the Secretary of State November 30, 2015.

 

 

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