Public health: Medi-Cal: nursing facilities.

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Existing law requires the department to impose a uniform quality assurance fee on each skilled nursing facility, with certain exceptions, in accordance with a prescribed formula. Existing law requires that the fee be based on the entire net revenue of all skilled nursing facilities subject to the fee. Under existing law, the fee may not be assessed after July 31, 2015, and these provisions will be repealed on January 1, 2016. Existing law, the Medi-Cal Long-Term Care Reimbursement Act, requires the department to implement a facility-specific reimbursement ratesetting system for certain skilled nursing facilities. Reimbursement rates for freestanding skilled nursing facilities are funded by a combination of federal funds and moneys collected pursuant to the skilled nursing uniform quality assurance fee. Existing law also establishes the Skilled Nursing Facility Quality and Accountability Special Fund in the State Treasury, which is a continuously appropriated fund that contains moneys from the assessment of specified administrative penalties and set asides of General Fund moneys, for the purposes of making quality and accountability payments. Under existing law, the rate methodology will become inoperative after July 31, 2015, and these provisions will be repealed on January 1, 2016. This bill would modify the calculation of rates under the above-referenced rate methodology, and would extend the assessment of the quality assurance fee, implementation of the rate methodology, as modified, and implementation of related provisions until July 31, 2020. By extending the period of time during which transfers are made to the Skilled Nursing Facility Quality and Accountability Special Fund, the bill would make an appropriation. The bill would also make changes to the amount of set-asides to be transferred to the fund. The bill would require the department, in coordination with the State Department of Public Health, to report specified information to the relevant Assembly and Senate budget subcommittees by May 1, 2016. This bill would include a change in state statute that would result in a taxpayer paying a higher tax within the meaning of Section 3 of Article XIIIA of the California Constitution, and thus would require for passage the approval of 23 of the membership of each house of the Legislature. This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.