The bill amends Section 40-8-19 of the General Laws concerning Medicaid payment rates to nursing facilities. It mandates the executive office of health and human services (EOHHS) to revert from a price-based reimbursement methodology back to a cost-based methodology for Medicaid payments. This change aims to ensure that the rates paid to nursing facilities are reasonable and adequate to cover the costs incurred by efficiently operated facilities.

The bill introduces new provisions, including the establishment of an incentive-based mechanism to reward facilities that meet specific performance, quality, or staffing benchmarks, as determined by the executive office. It also requires a comprehensive re-evaluation of Medicaid rates every three years, beginning October 1, 2025, using data from the most recent finalized cost reports to ensure that reimbursement reflects current direct and indirect care costs, patient acuity levels, and Medicaid occupancy rates.

Additionally, the bill specifies that commencing on October 1, 2021, and continuing until October 1, 2025, eighty percent (80%) of any rate increase resulting from the application of the inflation index shall be dedicated to increasing compensation for all eligible direct-care workers. The bill outlines that this increase will occur on October 1 of each year.

Statutes affected:
5144: 40-8-19