The proposed changes are as follows:
1.
Modify the methodology to adjust the reimbursement for nursing homes within the parameters of 2015-2017 Biennial Budget Bill. The number of Medicaid-funded patient days is projected to decline, which generates the overall funding decrease identified above. These modifications will include adjustments to the maximums, per diems, and other payment parameters in Sections 5.400, 5.500, 5.700, 5.800 and 5.900, the inflation and deflation factors in Section 5.300, and targets in Sections 3.000 and 5.000.2.
The methodology will factor in the effect on patient liability of the cost of living adjustment (COLA) increases in Social Security and Supplemental Security Income programs, effective January 1, 2015.3.
Potentially incorporate changes into the rate for ventilator-dependent residents under Section 4.691, as a result of further study the Department is carrying out in this area.4.
Potentially revise the approach to calculating the acuity-based rate adjustment established under a facility-specific case mix index using RUGS scores for the entire quarter under s. 2.140, as a result of further study the Department is carrying out in this area.5.
Revise Section 1.315 to align the definition of a patient day with Medicare payment principles and to better reflect current reimbursement procedures in Wisconsin’s MMIS:6.
Revise section 1.510 to clarify the longstanding Department policy that bed hold days may not be billed for a resident of a traumatic brain injury unit.7.
Potentially incorporate changes into the Behavioral/Cognitive Impairment Incentive, as a result of further study the Department is carrying out in this area.8.
Revise section 3.523 to clarify current audit practice relative to establishment of lease maximums for new or replacement facilities.9.
Update the Reporting Period and Dates Available in Sections 4.720, 5.421, and 5.422 10.
Modify contact names and addresses, as necessary.11.
Modify references to previous years for descriptive reasons, and correct typographical errors as necessary.12.
Modify the labor factors listed in Section 5.410. 13.
Modify the case mix weight listed in Section 5.420.14.
Change the dates of the definitions of base cost reporting period. Copies of the Proposed Changes:
Copies of the available proposed changes and proposed rates may be obtained free of charge by writing to:
Division of Long Term Care
Bureau of Long Term Care Financing
Attention: Nursing Home Medicaid Payment Plan
P.O. Box 7851
Madison, WI 53703-7851
or by faxing Dave Varana at 608-266-2713.
Written Comments/Meetings:
Written comments on the proposed changes may be sent to the Division of Long Term Care, at the above address. The comments will be available for public review between the hours of 7:45 a.m. and 4:30 p.m. daily in Room B274 of the State Office Building, 1 West Wilson Street, Madison, Wisconsin. Revisions may be made in the proposed changes based on comments received. There will also be public meetings to seek input on the proposed plan amendment. If you would like to be sent a public meeting notice, please write to the above address. Revisions may, also, be made in the proposed changes based on comments received at these forums.
