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Issues for the 84th Legislative Session
Legend is a leading independent owner and operator of skilled nursing facilities in Texas,
with 17 facilities across the state. The company is consistently regarded as one of the top
owner/operators in Texas and within each of its individual markets.
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1. Create a special committee to study the realities of skilled nursing care in Texas today and where
modernization of the industry’s regulatory oversight is needed.
a. Our current regulatory system is outdated and regulates a Nursing Facility (NF) system that has
evolved greatly over the last decade to include more skilled patients.
b. The legislature should create a special committee to conduct an overview of the state of the
industry with suggestions to modernize regulations and survey processes.
c. The special committee should be made up of legislators and public members appointed by the
Office of the Governor, Lieutenant Governor, and the Speaker of the House.
2. Preserve the nursing facility protections of Senate Bill 7 to ensure a smooth transition to managed
care in STAR+PLUS.
a. SB7 (83R) created certain protections for NF providers and patients entering the STAR+PLUS
Medicaid managed care program beginning on March 1, 2015.
b. Preserving and extending the NF Medicaid rate protection and additional NF protections will be
vital to ensuring providers can continue to deliver the highest quality healthcare, and patients can
continue receiving necessary services.
3. Protect Medicare rates to nursing facilities in the Dual Eligible Demonstration.
a. On March 1, 2015, a six county pilot is scheduled to transition NF patients dually eligible for
Medicaid and Medicare to an integrated managed care plan.
b. NFs are receiving rate quotes from the health plans of which significantly reduce the Medicare NF
rate; Lower Medicare rates will limit the ability to give patients necessary care and put NFs at
financial risk of going out of business.
c. The HHSC is supportive but needs legislative direction to protect Medicare rates in the roll out.
4. Remove the Informal Dispute Resolution (IDR) process from the HHSC to an independent third
party.
a. The current IDR and survey process are closely intertwined resulting in ineffective and potentially
biased IDR proceedings.
b. Using an independent third party is standard practice in many states and allows for a fairer
examination of survey deficiencies.
5. Improve transparency in the reporting of managed care money.
a. Transparency is critical to ensure funds are not diverted from patient care to managed care profits
through unwarranted Medicare and Medicaid provider payment cuts.
b. Reports should be accessible to patients and the public on dollars spent on patient healthcare vs.
dollars given to the managed care companies.
608 Sandau Rd.
San Antonio, TX 78216
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