UPDATE: Governor Hochul’s FY 2024-25 Executive Budget Proposal
Please find the following summary of certain specific initiatives impacting Skilled Nursing and Assisted Living providers included within Governor Hochul’s $233 billion FY 2024-25 Executive Budget. Medicaid Global Cap Extension: Makes statutory changes necessary to extend the two-year Medicaid Global Cap budgeting construct through FY 2026. The Medicaid Global Cap is a mechanism to place limits on Medicaid spending for each fiscal year. Capped spending is indexed to the five-year rolling average of Medicaid spending projections within the National Health Expenditure Accounts produced by the Office of the Actuary within CMS. Capital Rate Cut: The Governor’s Executive Budget proposes to reduce the capital component of the Medicaid rate for skilled nursing facilities by 10%, effective April 1, 2024 (includes any facilities eligible to refinance their mortgage loans via the Shared Savings Program), for a projected State savings of $28.5 million in FY 2025 and 2026, respectively. Medicaid Operating Costs and Case Mix Acuity: Suspends updates to the January 1, 2024 operating component of the Medicaid rate for skilled nursing facilities while the Department develops a methodology for patient acuity using the Patient Driven Payment Model (PDPM), as previously noted by DOH. Effective October 1, 2023, CMS no longer collects the data that current law specifies to weight a base price for patient acuity levels. During the period of suspension, the Department will work with critical stakeholders and develop a methodology to drive reimbursement that is consistent with levels of patient need within nursing homes. This operating component suspension will remain in place until a new methodology is tested and approved. Allows for Certified Medication Aides in Nursing Homes Authorizes the utilization of medication aides in skilled nursing facilities so they can administer routine medications to residents under the supervision of an RN. Joint Interstate Compacts: Authorizes New York State to enter into two separate interstate licensure compacts for medical professionals: the Interstate Medical Compact for licensed physicians and the Interstate Nurse Licensure Compact for RNs and LPNs. Managed Care Proposals: Makes several programmatic changes to the State’s delivery of Medicaid benefits through managed care organizations, including removing Medicaid from the independent dispute resolution process; and requiring the State to procure Medicaid managed care benefits from Medicaid Managed Care plans, Managed Long Term Care plans, Medicaid Advantage Plus plans, and Health and Recovery Plans. Additionally, the Governor’s Executive Budget proposes to eliminate the 1% across the board administrative rate increase provided to Medicaid managed care organizations as a result of the FY 2022-23 Enacted Budget. Permanent Special Needs Assisted Living Residence (SNALR) Voucher Program: Transitions the voucher program from a pilot program to a permanent program. The SNALR Voucher Program has been a demonstration program since being authorized in 2018. The program subsidizes the cost of assisted living for individuals with Alzheimer’s disease and dementia who are not eligible for Medicaid. By remaining as a pilot program, the SNALR Voucher Program is without regulations to clearly define the expectations of the participating facilities. By making the SNALR Voucher program permanent, the Department of Health would be able to promulgate regulations to define expectations and ensure uniformity. Assisted Living Residence Quality Reporting: Requires assisted living residences (ALRs) to report annually on specific quality and cost measures to the Department, who will assign each ALR a quality score. Top scoring ALRs would receive a classification of advanced standing and reduced surveillance requirements (once every 12-18 months). Facilities without such classification would be surveyed on an unannounced basis, no less than annually. Further, the proposal would permit adult care facilities who provide assisted living services to seek accreditation from nationally recognized accreditation agencies and, for the period of such accreditation, be exempt from duplicate State inspection requirements. CONTACTS: Stephen B. Hanse, Esq. President & CEO 518-462-4800 x.11 shanse@nyshfa.org Kristin A. DeVries, MA, MPP Director of Government Relations 518-462-4800 x.14 kdevries@nyshfa-nyscal.org Carl J. Pucci Financial Consultant 518-462-4800 x36 cpucci@nyshfa.orgRead More