§ 249L.3 — Quality assurance assessment — imposed — collection — deposit — documentation — civil actions

Iowa § 249L.3

• Jurisdiction: Iowa
• Title VI: HUMAN SERVICES
• Ch. 249L: NURSING FACILITY QUALITY ASSURANCE ASSESSMENT PROGRAM

Text

documentation — civil actions.
1. a. A nursing facility in this state shall be assessed a quality assurance assessment for
each patient day for the preceding quarter.
b. The quality assurance assessment shall be implemented as a broad-based health
care-related tax as defined in 42 U.S.C. §1396b(w)(3)(B).
§249L.3, NURSING FACILITY QUALITY ASSURANCE ASSESSMENT PROGRAM 2
c. The quality assurance assessment shall be imposed uniformly upon all nursing
facilities, unless otherwise provided in this chapter.
d. The aggregate quality assurance assessments imposed under this chapter shall not
exceed the maximum amount that may be assessed pursuant to the indirect guarantee
threshold as established pursuant to 42 C.F.R. §433.68(f)(3)(i), and shall be stated on a
per-patient-day basis.
2. The quality assurance assessment shall be paid by each nursing facility to the
department on a quarterly basis, or other schedule as determined by the department due to
a nursing facility’s noncompliance or based on an indication of a nursing facility’s financial
instability, after the nursing facility’s medical assistance payment rates are adjusted to
include funds appropriated from the quality assurance trust fund for that purpose. The
department shall prepare and distribute a form upon which nursing facilities shall calculate
and report the quality assurance assessment. A nursing facility shall submit the completed
form with the assessment amount no later than thirty days following the end of each
assessment period.
3. A nursing facility shall retain and preserve for a period of three years such books and
records as may be necessary to determine the amount of the quality assurance assessment
for which the nursing facility is liable under this chapter. The department may inspect and
copy the books and records of a nursing facility for the purpose of auditing the calculation
of the quality assurance assessment. All information obtained by the department under this
subsection is confidential and does not constitute a public record.
4. The department shall collect the quality assurance assessment imposed and shall
deposit all revenues collected in the quality assurance trust fund created in section 249L.4.
5. If the department determines that a nursing facility has underpaid or overpaid the
quality assurance assessment, the department shall notify the nursing facility of the amount
of the unpaid quality assurance assessment or refund due. Such payment or refund shall be
due or refunded within thirty days of the issuance of the notice.
6. a. A nursing facility that fails to pay the quality assurance assessment within the time
frame specified in this section shall pay, in addition to the outstanding quality assurance
assessment, a penalty of one and five-tenths percent of the quality assurance assessment
amountowedforeachmonthorportionofeachmonththatthepaymentisoverdue. However,
if the department determines that good cause is shown for failure to comply with payment of
the quality assurance assessment, the department shall waive the penalty or a portion of the
penalty.
b. If a quality assurance assessment has not been received by the department by the last
dayofthemonthinwhichthepaymentisdue, thedepartmentshallwithholdanamountequal
to the quality assurance assessment and penalty owed from any payment due such nursing
facility under the medical assistance program.
c. The quality assurance assessment imposed under this chapter constitutes a debt due
the state and may be collected by civil action, including but not limited to the filing of tax
liens, and any other method provided for by law.
d. Any penalty collected pursuant to this subsection shall be credited to the quality
assurance trust fund.
7. A nursing facility shall not knowingly pass on the quality assurance assessment to
non-Medicaid payors, including as a rate increase or service charge. If a nursing facility
violates this section, the department shall not reimburse the nursing facility the quality
assurance assessment due the nursing facility under the medical assistance program, but
shall instead only reimburse the nursing facility at the nursing facility base reimbursement
rate under the medical assistance program for one year from the date the violation is
discovered.
8. If federal financial participation to match the quality assurance assessments made
under this section becomes unavailable under federal law, the department shall terminate
the imposition of the assessments beginning on the date the federal statutory, regulatory, or
interpretive change takes effect.