Final Enacted FY2024-25 State Budget Released
The Legislature released the agreed upon Health and Mental Health (HMH) Article VII State Budget bill earlier today with voting set to begin mid-afternoon, coming weeks after the April 1 deadline. The following is a summary of some of the provisions included in the FY2024-25 Enacted State Budget affecting skilled nursing and assisted living providers.
Medicaid Rate Increase
For Skilled Nursing Facilities:
The final Enacted State Budget increases the Medicaid reimbursement rate for skilled nursing facilities by $285,000,000 (State and federal share) for the period of April 1, 2024 through March 31, 2025. This amount equates to an approximate 4.38% Medicaid rate increase. There is no specific distribution methodology set forth in the bill language. This Medicaid rate increase is in addition to the 1% increase currently in effect and still pending payment to providers.
For Assisted Living Providers:
The final Enacted State Budget increases the Medicaid reimbursement rate for assisted living providers by $15,000,000 (State share) for the period of April 1, 2024 through March 31, 2025. This amount equates to an approximate 4% Medicaid rate increase. There is no specific distribution methodology set forth in the bill language. This Medicaid rate increase is in addition to the 1% increase currently in effect and still pending payment to providers.
Managed Care Organization (MCO) Tax
The final Enacted State Budget institutes an MCO provider tax to secure federal financial participation for Medicaid costs, issue regulations to implement the tax, and impose such tax as an assessment upon insurers, HMOs, and Medicaid MCOs. Further, the State Budget creates a healthcare stability fund to receive funds as a result of the MCO provider tax. Funds collected can be used to increase provider Medicaid rates and reimburse the general fund for incurred Medicaid expenditures, among other things.
Case Mix Freeze
The final Enacted State Budget includes the Governor’s original proposal to freeze the case mix date effective July 1, 2023 until full implementation of the Patient Driven Payment Model (PDPM) case mix methodology occurs.
Capital Rate for SNFs and ALPs
The final Enacted State Budget institutes an additional 10% capital rate cut for both SNFs and ALPs. This excludes pediatric residential health care facilities.
Medicaid Rebasing
The final Enacted State Budget does not include language to rebase Medicaid rates for SNFs and/or ALPs.
MCO Uniform Rate Increase
The final Enacted State Budget eliminates the 1% uniform rate increase paid by the State to Medicaid MCOs.
Nursing Home Vital Access Provider Program (VAPAP)
Includes the Governor’s proposal to decrease nursing home VAPAP funding from $100M to $25M annually.
Special Needs Assisted Living Residence Voucher Program
Makes permanent the SNALR voucher program and removes any caps to vouchers as previously proposed, subject to appropriation. This program subsidizes payments for individuals with Alzheimer’s and other forms of dementia who reside in a SNALR, up to 75% of their cost. It was originally instituted as a demonstration program and new applications were paused in July 2023 due to overwhelming demand.
Assisted Living Quality Reporting Standards
Does not include provisions to create quality reporting standards and accreditation processes for ALRs.
ADDITIONAL PROVISIONS:
Certified Medication Aides
The final Enacted State Budget does not include provisions to allow certified medication aides to work in SNFs. This will likely be addressed as a post-Budget issue (A.8299, Clark/S.8635, Cooney).
Interstate Licensure Compact and Nurse Licensure Compact
Not included.
Consumer-Directed Personal Assistance Program (CDPAP)
The final Enacted State Budget creates a statewide fiscal intermediary (FI) for CDPAP to control exponential growth and fraudulent practices. The statewide FI may contract with at least one entity per rate setting region that has a proven track record of delivery services to elderly populations. Payments to subcontracted entities will be made by the statewide FI and all subcontractors must register with the State.
Telehealth Extension
The final Enacted State Budget extends the provisions relating to reimbursement for commercial and Medicaid telehealth services from April 1, 2024 to April 1, 2026.
Cost-of-Living Adjustment (COLA)
The final State Enacted Budget includes a 2.84% cost of living adjustment (COLA) for certain housing programs to account for inflationary trends. Programs eligible include OMH, OPWDD, OASAS, and SOFA-licensed facilities. Additionally, the final State Budget includes a 1.7% COLA salary increase for eligible workers.
Statewide Healthcare Safety Transformation Program
The final Enacted State Budget creates this Program to support safety net hospitals to improve access, equity, quality, and outcomes. While applicable to hospitals, skilled nursing facilities and other healthcare entities may serve as partner organizations to the safety net hospital and thereby by able to receive an award as part of this collaborative relationship to transform the hospital.
NYSHFA | NYSCAL will continue to provide updates as further FY 2024-25 State Budget information becomes available.
NYSHFA | NYSCAL CONTACTS:
Stephen B. Hanse, Esq.
President & CEO
518-462-4800 x11
Kristin DeVries, MA, MPP
Director of Government Relations
518-462-4800 x14
Carl Pucci
Financial Consultant
518-462-4800 x36
