(1) There is hereby created in the office of the state treasurer a dedicated fund to be known as the nursing facility assessment fund, hereinafter the "fund," to be administered by the department. The state treasurer shall invest idle moneys in the fund and any interest received on those investments shall be returned to the fund.
(2)  Moneys in the fund shall consist of:
(a)  All moneys collected or received by the department from nursing facility assessments required pursuant to this chapter;
(b)  All federal matching funds received by the department as a result of expenditures made by the department that are attributable to moneys deposited in the fund;
(c)  Any interest or penalties levied in conjunction with the administration of this chapter; and
(d)  Any appropriations, federal funds, donations, gifts or moneys from any other sources.
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Terms Used In Idaho Code 56-1504

  • CMS: means the centers for medicare and medicaid. See Idaho Code 56-1503
  • Department: means the department of health and welfare. See Idaho Code 56-1503
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • Fiscal year: means the time period from July 1 to June 30. See Idaho Code 56-1503
  • Fund: means the nursing facility assessment fund established pursuant to section 56-1504, Idaho Code. See Idaho Code 56-1503
  • Nursing facility: means a nursing facility as defined in section 39-1301, Idaho Code, and licensed pursuant to chapter 13, title 39, Idaho Code. See Idaho Code 56-1503
  • State: when applied to the different parts of the United States, includes the District of Columbia and the territories; and the words "United States" may include the District of Columbia and territories. See Idaho Code 73-114
  • Value-based purchasing payments: means supplemental payments effective in state fiscal year 2021 made to providers for reaching department-selected quality indicators. See Idaho Code 56-1503
(3)  The fund is created for the purpose of receiving moneys in accordance with this section and section 56-1511, Idaho Code. Collected assessment funds shall be used to secure federal matching funds available through the state medicaid plan, which funds shall be used to make medicaid payments for nursing facility services that equal or exceed the amount of nursing facility medicaid rates, in the aggregate, as calculated in accordance with the approved state medicaid plan in effect on June 30, 2009. The fund shall be used exclusively for the following purposes:
(a)  To pay administrative expenses incurred by the department or its agent in performing the activities authorized pursuant to this chapter, provided that such expenses shall not exceed a total of one percent (1%) of the aggregate assessment funds collected for the prior fiscal year.
(b)  To reimburse the medicaid share of the assessment in accordance with IDAPA 16.03.10.264.
(c)  To provide financial incentives for nursing facilities to improve quality to be implemented as value-based purchasing payments in state fiscal year 2021 based on performance data from the prior state fiscal year, in accordance with section 56-1511, Idaho Code.
(d)  To increase nursing facility payments to fund covered services to medicaid beneficiaries within medicare upper payment limits, as negotiated with the department.
(e)  To repay the federal government any excess payments made to nursing facilities if the state plan, once approved by CMS, is subsequently disapproved for any reason, and after the state has appealed the findings. Nursing facilities shall refund the excess payments in question to the assessment fund. The state, in turn, shall return funds to both the federal government and nursing facility providers in the same proportion as the original financing. Individual nursing facilities shall be reimbursed based on the proportion of the individual nursing facility’s assessment to the total assessment paid by nursing facilities. If a nursing facility is unable to refund payments, the state shall develop a payment plan and deduct moneys from future medicaid payments. The state will refund the federal government for the federal share of these overpayments.
(f)  To make refunds to nursing facilities pursuant to section 56-1507, Idaho Code.