SB278 Alabama 2020 Session

Summary

Primary Sponsor

Greg AlbrittonSenator

Republican

Session

Regular Session 2020

Title

Privilege assessments, assessment increased, methodology for recalculation of assets provided, quality incentive program for nursing facilities, Secs. 40-26B-21, 40-26B-26, 40-26B-27 am'd.

Summary

SB278 would raise nursing facility privilege assessments, define a new method for recalculating current asset value used in Medicaid rate setting, and authorize a quality incentive program funded by Medicaid to reward facilities for quality measures.

What This Bill Does

The bill increases the annual per-bed privilege assessment by $327.48 starting September 1, 2020, with the higher amount paid monthly and folded into the existing assessment, and it will be included in Medicaid per diem payments beginning October 1, 2020. It creates a prescribed method to recalculate current asset value (adding 41.03% to the June 30, 2020 rebasing) for rate calculations, with future rebasing continuing under existing rules. It authorizes a Medicaid quality incentive program for nursing facilities, funded by at least $5 million per scoring year, to be paid as a lump sum based on selected CMS quality measures and independent customer satisfaction categories, rewarding facilities that improve or rank above national averages. It also maintains and integrates supplemental and secondary supplemental privilege assessments and provides for adjustments if federal participation is not available, including provisions related to rate ceilings and special ventilator-unit reimbursements.

Who It Affects

• Nursing facilities in Alabama: will pay higher privilege, supplemental, and secondary privilege assessments, and these costs will be reflected in Medicaid per diem reimbursements; they may also be eligible for quality incentive payments if they meet the scoring criteria.
• Alabama Medicaid Agency and the state's Medicaid nursing facility program: must implement the new rate recalculation method, administer the increased assessments and associated payments, manage the quality incentive fund, and ensure alignment with federal participation rules.

Key Provisions

• Privilege assessment per bed increases by $327.48 per year starting September 1, 2020 (from $1,899.96 to $2,227.44 total), with the increase paid in equal monthly installments and merged into the base privilege assessment.
• The added privilege assessment amount will be included in Medicaid per diem rates for services starting October 1, 2020, and the Medicaid Agency will calculate the October 1, 2020 adjustment using total resident days from the cost report ending June 30, 2019, annualized if needed.
• A recalculation of each nursing facility's current asset value (used to set rates) will occur by adding 41.03% of the June 30, 2020 rebasing to the facility's current asset value, with annual rebasing continuing under the existing code; rate increases from this recalibration, if any, will be effective for services on or after October 1, 2020.
• The bill authorizes a quality incentive program funded with at least $5,000,000 per scoring year, awarding lump-sum incentives based on (i) five CMS quality measures and (ii) three NRC Health or equivalent customer satisfaction categories; facilities must show improvement or rank at or above national average to earn points.
• The act preserves and interacts with existing supplemental and secondary supplemental privilege assessments and requires that total privilege-related revenues be treated as allowable costs in Medicaid rate calculations, with adjustments for cost ceilings as needed.
• The Medicaid program may also implement a special reimbursement model for ventilator units in facilities meeting certain requirements, and the act includes severability provisions if federal funding participation is not available.

AI-generated summary using openai/gpt-5-nano on Feb 23, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Nursing Facilities