§346F-10  Enhanced rates to medicaid managed care health plans.  [See Note at chapter heading.]  In accordance with title 42 Code of Federal Regulations part 438, the department shall use revenues from the nursing facility sustainability fee and federal matching funds to enhance the capitated rates paid to medicaid managed care health plans for the period of July 1 through December 31, 2021, and calendar years 2022 and 2023, consistent with the following objectives:

     (1)  The rate enhancement shall be used exclusively for increasing reimbursements to private nursing facilities to support the availability of services and to ensure access to care to the medicaid managed care health plan enrollees;

     (2)  The rate enhancement shall be made part of the monthly capitated rates by the department to medicaid managed care health plans, which shall provide documentation to the department and the nursing facility trade association located in Hawaii certifying that the revenues received under paragraph (1) are used in accordance with this section;

     (3)  The rate enhancement shall be actuarially sound and approved by the federal government for federal fund participation;

     (4)  The department shall modify the fee-for-service reimbursement rates of the nursing facilities to recognize the medicaid portion of the nursing facility sustainability fee as an additional cost of serving medicaid patients, and to provide a uniform percentage increase in preexisting facility-specific rates; and

     (5)  Payments made by the medicaid managed care health plans shall be made within thirty calendar days upon receipt of monthly capitation rates from the department. [L 2012, c 156, pt of §2, §5; am L 2013, c 142, §§2(3), 3; am L 2014, c 124, §§1(2), 2; am L 2015, c 69, §§1(3), 2; am L 2016, c 59, §§1(2), 2; am L 2017, c 60, §§3, 5; am L 2019, c 163, §§4, 6; am L 2021, c 24, §5]