NFRA Trust Fund

Proposed legislation would require the Health and Human Services Commission to establish a uniform and broad based reinvestment allowance fee for each patient day in an amount that will produce annual fees from all nursing facility providers that will not exceed the maximum that may be assessed under federal law.

Revenue generated by the reinvestment allowance would be used to create a dedicated trust which would enable Texas to secure hundreds of millions of federal match Medicaid dollars Texans now lose. Funds from the trust will be returned to nursing facilities as a rate enhancement added to the base rate set by HHSC.

Close the funding gap for Texas nursing homes

Federal Medicaid dollars recaptured with the NFRA will be used by the state to enhance the base nursing home reimbursement rate for the Medicaid program. The additional funding reduces the Medicaid reimbursement shortfall for nursing facilities with no cost to general revenue.

Dedicated to improving quality through value-based incentive payments

Nursing facilities in Texas would receive tens of millions of dollars in new money dedicated to improving quality of care. Ten percent of the net increase in funding would be statutorily tied to value-based quality payments.

Funds Will Cover MCOs Costs for Administering Program

Five percent of the funds generated by the NFRA Program will be paid to the Medicaid Star+Plus Managed Care Organizations (MCOs) to cover their costs associated with administering the program.

Enhanced Rates Must Be Paid to Nursing Facilities

As required by statute, HHSC will update the minimum rate paid to nursing facilities to ensure MCOs pay the enhanced base rate to nursing home providers resulting from the NFRA.

What it prohibits

A nursing facility may not include the NFRA as a separate charge on a patient’s or resident’s billing statement or otherwise directly or indirectly attempt to charge the allowance to a patient or resident.