ENROLLED HOUSE
BILL NO. 2778	By:	Steele, Billy, Shelton, Morrissette, Denney, McDaniel (Jeannie), Tibbs, Inman, Collins and Pittman of the House

			and

		Crain of the Senate

An Act relating to poor persons; amending Section 5, Chapter 315, O.S.L. 2006 (56 O.S. Supp. 2009, Section 1011.5), which relates to an incentive reimbursement rate plan for nursing facilities; requiring that the Oklahoma Health Care Authority make certain refinements to the plan; requiring annual report to certain individuals; and providing an effective date.

BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:

SECTION 1.     AMENDATORY     Section 5, Chapter 315, O.S.L. 2006 (56 O.S. Supp. 2009, Section 1011.5), is amended to read as follows:

Section 1011.5  A.  The Oklahoma Health Care Authority in cooperation with the State Department of Health, a statewide organization of the elderly, representatives of the Health and Human Services Interagency Task Force on long-term care, and representatives of both statewide associations of nursing facility operators shall develop an incentive reimbursement rate plan for nursing facilities that shall include, but may not be limited to, the following:

1.  Quality of life indicators that relate to total management initiatives;

2.  Quality of care indicators; 

3.  Family and resident satisfaction survey results;

4.  State Department of Health survey results;

5.  Employee satisfaction survey results;

6.  CNA training and education requirements;

7.  Patient acuity level;

8.  Direct care expenditures pursuant to subparagraph e of paragraph 2 of subsection I of Section 1-1925.2 of Title 63 of the Oklahoma Statutes; and

9.  Other incentives which include, without limitation, participation in quality initiative activities performed and/or recommended by the Oklahoma Foundation for Medical Quality in capital improvements, in-service education of direct staff, and procurement of reasonable amounts of liability insurance.

B.  The Oklahoma Health Care Authority shall negotiate with the Centers for Medicare and Medicaid Services to include the authority to base provider reimbursement rates for nursing facilities on the criteria specified in subsection A of this section.

C.  The Oklahoma Health Care Authority shall make refinements to the incentive reimbursement rate plan to ensure transparency and integrity.  These refinements shall include, but may not be limited to, the following:

1.  Establishing minimum standard for incentive payments, through higher percentiles using evidence-based criteria or introduction of absolute standards above the current benchmark;

2.  Using state survey results as a threshold metric for determining if facilities should receive incentive payment and suspend facilities falling below the threshold;

3.  Taking steps to strengthen data collection process; and

4.  Establishing an advisory group with consumer, provider and state agency representation to provide feedback on program performance and recommendations for improvements.

D.  The Oklahoma Health Care Authority shall provide an annual report of the incentive reimbursement rate plan to the Governor, the Speaker of the House of Representatives, and the President Pro Tempore of the Senate by December 31 of each year.  The report shall include, but not be limited to, an analysis of the previous fiscal year including incentive payments, ratings, and notable trends.  

SECTION 2.  This act shall become effective November 1, 2010.  

Passed the House of Representatives the 17th day of May, 2010.

	
Presiding Officer of the House of
	Representatives

Passed the Senate the 21st day of May, 2010.

	
Presiding Officer of the Senate