SB 684

Under current law, the Department of Health Services administers the Medical

Assistance (MA) program to provide health care and long-term care services to MA

recipients, who are, generally, low-income, elderly, or disabled people who meet

other specific eligibility requirements. A provider of services under MA must accept

the MA payment, plus any permitted coinsurance, as payment in full. A provider

may not accept, and a third party may not pay a provider, any supplemental payment

for a service provided under MA. Further, a facility that is an MA provider may not

charge a fee for admission or continued placement of an MA recipient.

This bill provides that if two or more counties, cities, towns, or villages (political

subdivisions) create a commission to operate a nursing home and the commission

imposes assessments on the participating political subdivisions for the costs of

operating the nursing home and providing services to residents, payment of the

assessments by the political subdivisions and acceptance of the assessments by the

commission do not violate prohibitions against supplementing MA payments or

billing a third party for MA services. Under the bill, the commission must satisfy

certain conditions, including that the commission is the licensee of the nursing home;

the commission owns or leases the building in which the nursing home is located; the

commission controls admissions to and discharges from the nursing home; and the

commission provides, or contracts for, MA services to the residents of the nursing

home.