§ 42-8-103 — Nursing care facility assessment account

(a) The nursing care facility assessment account is
created.
(b) The state treasurer shall invest amounts deposited
within the account in accordance with law, and all investment
earnings shall be credited back to the account.
(c) The account shall consist of:
(i) Amounts collected or received by the department
from nursing care facility assessments under this article;
(ii) All federal matching funds received by the
department as a result of expenditures made by the department
attributable to the account;
(iii) Any interest or penalties levied in conjunction
with the administration of this article.
(d) The account is created for the purpose of receiving
funds as specified in this section. Collected assessment funds
shall be used to secure federal matching funds available through
the state Medicaid plan, which shall be used to make Medicaid
payments for nursing care facility services which exceed the
amount of nursing care facility Medicaid rates, in the
aggregate, as calculated in accordance with the approved state
Medicaid plan in effect on October 1, 2010. The fund shall be
used exclusively for the following purposes:
(i) To pay administrative expenses incurred by the
department or its agent in performing the activities authorized
by this article, provided that such expenses shall not exceed a
total of one percent (1%) of the aggregate assessment funds
collected in the fiscal year;
(ii) To increase nursing care facility payments to
fund covered services to Medicaid beneficiaries within Medicare
upper payment limits, as negotiated with the department. The
upper payment limit for private nursing care facilities, state
government-owned facilities and nonstate government-owned
nursing facilities shall be calculated by the department using
the higher of the cost-based or prospective payment system
approach in accordance with the provisions of 42 C.F.R. 447.272;
(iii) To repay the federal government any excess
payments made to nursing facilities if the state plan, after
approval by the federal centers for Medicare and Medicaid
services, is subsequently disapproved for any reason and after
the state has appealed. Nursing care facilities shall refund
the excess payments to the assessment account. The department
shall return the excess payments to the federal government and
nursing care facility providers in the same proportion as the
original financing. Individual nursing care facilities shall be
reimbursed based on the proportion of the individual nursing
care facility's assessment to the total assessment paid by
nursing care facilities. If a nursing care facility is unable
to refund payments as provided in this paragraph, the department
shall develop a payment plan and deduct amounts from future
Medicaid payments. The department shall refund the federal
government for the federal portion of those overpayments; or
(iv) To make quarterly adjustment payments as
provided in W.S. 42-8-108.