DOH Monthly Briefing – August 2022
DOH held its Monthly Briefing earlier today. The following summarizes the topics discussed:
70/40/5 Law Amendments – The final Executive Budget excluded the cash receipts assessment from the definition of revenue. Also excluded from the revenue definition was the capital per diem portion of the rate for CMS four- and five-star facilities that are not attributable to a capital expenditure made to an entity with a common familial ownership. The associations requested additional guidelines related to implementation of the staffing requirements as well as the associated $64M state funding to be provided.
NYSHFA, through its General Counsel, submitted comments directly to CMS regarding the proposed 70/40 State Plan Amendment (SPA), which was filed by DOH in early July. The comments clarified the direct care revenue exclusions adopted by the Governor’s Executive Budget. The comments also noted the SPAs planned use of Federal Medicare reimbursement to fund the state’s Medicaid program is a major concern.
Healthcare Workers Bonus (HWB) – The HWB was launched on 8/3/22 (see NYSHFA member mailing). DOH rate-setting is not directly involved in the HWB processing and recommended all provider questions be referred to the call center or web address in the above NYSHFA link.
1/1/22 Rates – The January 1, 2022 rate were posted to the HCS in early July, reflecting an updated case mix, 2022 minimum wage adjustment and a revised 1.5% ATB investment adjustment. The 2022 capital rates recently have been approved and will be loaded into the rate setting system. The 1/1/22 Benchmark rates will then be updated.
7/1/22 Rate / MDS Data Collection – The MDS data collection for the upcoming July 2022 Medicaid rates is currently underway. Members should have reviewed their census data and made appropriate changes for all assessments for the period 10/1/21 through 3/31/22. Final MDS certifications are due this Friday, August 12, 2022.
5% MDS Cap Release – The 5% MDS Cap is no longer in regulation. As such, DOH will process payments/recoupments attributable to the cap for the period 7/1/17 – 1/1/21. DOH will issue lump-sum payments for those providers who are due monies related to the 5% cap. For providers who owe recoupments due to the cap, DOH will apply the standard weekly 15% recoupment until all monies are repaid. Specific year-to-year payments and/or recoupments will be netted into one provider transaction. DOH indicated that this revision is still in process.
2022 ALP Rates – The 4/1/22 ALP rates were issued on 8/4/22. The rates included a 1% operating increase, which members should have received in Medicaid cycle #2342 (check date 7/27/22).
2017 – 2021 ALP Minimum Wage Rates – DOH has updated rates for provider-specific corrections, which will be processed in upcoming Medicaid cycle #2347 (check release date 8/31/22).
2017/18 OMIG Audits – The 2017 MDS audits are nearly complete. OMIG expects to begin the 2018 audit field work in early Fall.
NYSHFA/NYSCAL CONTACT:
Carl J. Pucci
Chief Financial Officer
518-462-4800 x36
