NYS DOH Issues DAL- Changes to the MDS Collection Period & Certification Form/Webinar July 7th

This DAL provides information regarding changes to the Minimum Data Set (MDS) data collection periods effective beginning with the July 2021 Medicaid reimbursement rates. NEW: In accordance with recently adopted regulation, https://regs.health.ny.gov/content/section-86-240-statewide-prices-non-capital-reimbursement the following changes have been made to the MDS process.

• The census dates in January and July have been eliminated.
• The case mix index is now calculated using an AVERAGE of ALL Medicaid assessments.
• The case mix index for the July 2021 rates will include ALL assessments submitted to CMS from October 1, 2020 through March 31, 2021.
• Facilities will no longer select residents to include in the census.
• Consistent with past practice, facilities will continue to review and make necessary updates (payor source, TBI, BMI, Dementia, Authorized Specialty) to their file on the HCS.
• The 5% cap on case mix index increases or decreases from the previous rate period has been eliminated.
• The MDS Certification form has been amended and continues to be required. The Certification form required for reporting starting in July, 2021 accompanies this letter.
• Please note, if your certification is not received by July 30, 2021, the Department will use your facility’s prior case mix index to calculate rates.
• Additionally, Public Health Law §12 authorizes the Department to access a penalty of up to $2,000 for each violation of any regulation.

The Department considers each day that a certification is not submitted by the due date to be a separate violation of 10 NYCRR 86-2.40 (m). The Department will be holding a webinar on Wednesday, July 7, 2021 at 1:00 pm to present the new process. This presentation (New Process – MDS for Reimbursement) will also be posted on HCS. Please use the following link to register for the webinar on the July 2021 CMI Collection:

https://meetny.webex.com/meetny/onstage/g.php?MTID=e7f611260117440168c6a4466d501bbf7

See attached DAL & Certification. 

NYSHFA/NYSCAL CONTACTS:

Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15

Carl J. Pucci
Chief Financial Officer
518-462-4800 x36