Senate Bill 143 Alabama 2026 Session

Summary

Primary Sponsor

Greg AlbrittonSenator

Republican

Session

2026 Regular Session

Title

Nursing facilities, privilege assessments and surcharge on each nursing home bed, sunset clause removed

Summary

SB143 would remove the sunset on nursing facility privilege assessments and surcharges, making them permanent and updating how Medicaid pays nursing homes to reflect those revenues.

What This Bill Does

It keeps the per-bed privilege assessment and the associated supplemental assessments and surcharge in place permanently (no sunset). It directs Medicaid to reimburse nursing facilities using the updated reimbursement methodology in Title 560-X-22 as of May 1, 2026, with specified cost ceilings and adjustments that treat the assessments as allowable costs in per diem rates. It allows rate reductions if total revenues from these assessments are less than 6% of a facility's total revenues in a fiscal year, and requires corresponding adjustments to per diem calculations. It also introduces asset value rebasing for rate calculations starting in 2020, potential quality incentive programs, and a possible special reimbursement model for ventilator units, with an overall effective date of June 1, 2026.

Who It Affects

• Nursing facilities and their operators: they would continue to pay per-bed privilege assessments, supplemental assessments, and surcharges permanently, and their Medicaid reimbursements would be adjusted to reflect these costs.
• Alabama Medicaid Agency and Medicaid beneficiaries (nursing home residents): Medicaid rate calculations, ceilings, and potential incentives would change, affecting how much Medicaid pays to facilities and how residents’ long-term care is funded.

Key Provisions

• Removes the August 31, 2028 sunset date for the privilege assessment, the supplemental privilege assessment, and the surcharge on nursing facility beds, making them permanent.
• Maintains a base per-bed privilege assessment of $1,899.96 and establishes ongoing annual increases (example: an additional $327.48 per bed per year) that merge into the base assessment and are treated as part of Medicaid-reimbursed costs.
• Maintains supplemental and secondary supplemental privilege assessments with per-bed rates (e.g., $1,063.08, then $1,603.08 for certain periods) and a monthly surcharge structure (initially $131.25 per bed, later reduced to $43.75); includes a secondary supplemental assessment at $401.28 per bed (Oct 2015–Aug 2028).
• Requires Medicaid to reimburse facilities using the Chapter 560-X-22 methodology in effect as of May 1, 2026, with ceilings for operating and direct patient care costs and related adjustments, and to include all privilege assessments and surcharges as allowable costs in per diem calculations.
• Sets specific ceilings and adjustment rules for rate computations: operating cost center ceiling at median plus 5%; direct patient care ceiling at median plus 10% or actual cost plus 11% or ceiling plus 11%, whichever is less; inflation indexing and annual ceiling increase limits tied to a Medicaid Inflation Index plus 4%; adjustments for certain equipment and specialized care costs.
• Allows a special reimbursement model for dedicated ventilator units and a quality incentive program funded with at least $5 million per scoring year, using CMS quality measures and independently collected patient-satisfaction measures to determine awards.
• Authorizes asset value rebasing starting July 1, 2020 (including a 41.03% increase to the June 30, 2020 rebasing value), with annual rebasing thereafter, and requires rate increases to be effective October 1, 2020 for the rebasing-adjusted rates.
• Gives the Medicaid agency authority to adjust ceilings or reimbursements in response to emergencies, federal/state changes, or extraordinary events, and to correct material data errors during rate setting.

AI-generated summary using openai/gpt-5-nano on Feb 12, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Taxation & Revenue