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Reimbursement and cost report changes: training for long term care providers

Pursuant to 2012 Legislation House Bill 421, Section 5, the Division of Medicaid (DOM) requested legislative approval to implement changes to the current reimbursement methodology for nursing facilities (NF), psychiatric residential treatment facilities (PRTF), and intermediate care facilities for individuals with intellectual disabilities (ICF/IID), effective Jan. 1, 2015, pending approval from the Centers for Medicare and Medicaid Services (CMS). In addition, DOM requested approval to make payment for ventilator dependent residents using a separate per diem rate. Compositely, these changes are expected to be near budget neutral.

The 2012 Mississippi Legislature passed House Bill 421, Section 5, with a directive to DOM to do the following:

  • develop a plan providing revisions to the current reimbursement methodology, and
  • not implement these plans, but submit to the Legislature.

In response to the directive , DOM held an open forum meeting in June, 2012, and a workgroup was formed, comprised of the LTC industry representatives, DOM staff, other state agencies, consultants and other interested parties.

  • The workgroup met multiple times in Jackson between July 2012 and November 2013 to develop recommendations and reimbursement models for consensus.
  • The resultant consensus report, Mississippi Division of Medicaid, ‘Nursing Facility Reimbursement Methodology Revision Report’ was presented to the Mississippi Legislature in January 2014.
  • During the 2014 Legislative Session, House Bill 1275 authorized DOM to make changes in the reimbursement methodology for all LTC facilities.

For more specific information, review the following presentation: Reimbursement and cost report changes: training for long term care providers