DOH held its Monthly Briefing earlier today. The following summarizes the topics discussed:
7.5% Rate Increase – DOH submitted the State Plan Amendment (SPA) to CMS and it is presently under review. The SPA requests approval for the full 7.5% rate increase. The DOH could not provide a timeline for CMS approval. A question was raised as to whether the DOH would release the state share in advance of CMS SPA approval. While the DOH indicated that it is procedurally much easier to front the State share of a lump sum payment as opposed to a rate payment, the Department indicated that it would investigate the matter further.
October MDS/CMI Change – DOH is going to freeze case mix for the 1/1/24 collection period (4/1/23 – 9/30/23) as they work to revise the methodology. The Department stated that they are seeking a broader solution and will engage support from associations as they continue to work on this transition. DOH further indicated that a solution may be included within the context of the FY 2024-25 State budget.
July 2023 Rates – No timeline for rate release, in review.
Cinergy Payment – Both the Federal 2022-23 and the State 2023-24 payments have been approved by DOB.
Capital Rates/2023 Appeals – 2023 appeals in-house, starting review process. The Department will provide more information when further along.
Process for historic appeals (from 2009) to begin shortly within the context of the current financial cap. DOH will be conducting an informational webinar in the next couple of weeks on the process. The DOH will identify a subset of appeals. Providers will be asked to submit financial information and an attestation, subject to audit. There is no timeline for final approvals/denials.
Enhanced ATI – Payments related to the Enhanced ATI for the period 4/1/23 through 3/31/24 will be processed in upcoming Medicaid cycle #2402 (check date 9/20/23). See attached DAL with further details.
2022 CRA Reconciliation – Remains in process, as additional time from the 2022 FY is required to complete the reconciliation.
2% Quality Penalty – Updated in the system, effective cycle #2401 (check release date 9/13/23).
2022 Cost Report – The vast majority of providers have now submitted their 2022 cost reports, some with formal extensions.
IGT/UPL – The Department of Health continues to work with CMS to provide all necessary information to enable CMS approval of the 2022 State Plan Amendment related to the UPL and associated payments.
Please contact NFRates@health.ny.gov with “2022 NH UPL” in the subject line if you have any questions. DOH has had positive interactions with CMS and expects to have an update soon.
MDS audits – OMIG reported that the 2018 audits are completed in the Capital District, Central NY, Buffalo, and Westchester regions. OMIG is currently working on audits in NYC and Long Island. They have issued 56 summation letters and terminated 2 audits. Draft audits should be mailed in September.
Minimum Wage Adjustment AL (January 2023) – The DOH is utilizing a reconciliation approach and will conduct a survey at end of 2023; to result in retro payment going back the full year.
NYSHFA | NYSCAL CONTACT:
Carl J. Pucci