DOH Monthly Briefing – February 2024
DOH held its Monthly Briefing earlier today. The following summarizes the topics discussed:
2% Supplemental Rate / 2022 NHQI
The 2% supplemental payments have just been approved. DOH is working with eMedNY to finalize the lump-sum payment adjustments and will release a DAL with further information in the next few weeks. The 2% supplemental rate package is not linked to the 2022 NHQI calculation as in previous years in order to be released ahead of the NHQI processing timeline. The NHQI payment adjustments are currently under executive review. DOH will be updating their website for the NHQI rankings in the next day or so.
7.5% Rate Increase
DOH has posted nursing home rate sheets reflecting the 6.5% increase to Medicaid rates that is retroactive to April 1, 2023. Payment was made in Medicaid cycle #2408 (check release 11/2/23). The State Plan Amendment (SPA) to CMS requests approval for the federal match of the 7.5% rate increase. DOH is still seeking CMS approval of the SPA and has not received further guidance.
1/1/2024 Notice Rates
The 2024 notice rates are posted on the Health Commerce System (HCS) under the heading of 2024 Notice Rates. The all-inclusive rates provided on the Gateway include the following components:
- Operating Component: The non-specialty rates reflect the pricing methodology, with the updated case mix as well as the 2024 minimum wage adjustment to be added prospectively.
- Capital Component: The capital component of the 2024 notice rates are based upon the facility’s 2022 cost report.
Updates to the initial notice rates are still being developed.
2022 CRA Reconciliation
The 2022 Cash Receipts Reconciliation is under executive review. No timetable for release was given.
Capital Rates /Appeal Process
DOH is reviewing the in-house 2023 appeals (including historic appeals from 2009) within the context of the current appeals cap. All 2024 capital attestations have been received and DOH has begun the related rate-setting process.
Safe Staffing
The State Share of funding to assist nursing homes in meeting staffing level requirements was contained in Medicaid cycle #2377 (check release date 3/29/23). DOH is working with CMS on the related SPA, and upon approval, a second lump distribution will be made for the federal share. DOH conducted a webinar on 7/6/23 regarding the minimum staffing level compliance reviews, which has been archived. DOH is directing any further questions on safe staffing or the 70/40 spending cap to NHSafeStaffing@health.ny.gov. No further information is available at this time.
PDPM
DOH recognizes the importance of the 10/2023 assessment changes related to PDPM. They are not planning on moving to the Optional State Assessment (OSA) for collection of data, but rather are developing a plan to change to PDPM. The final RUGs related rates will be processed on January 1, 2024. Subsequently, a rate freeze will be in effect for the 1/1/24 collection period (4/1/23 – 9/30/23), as DOH works on this transition. DOH further indicated that a solution may be included within the context of the FY 2024-25 State Budget. DOH is in the early stages of this process and reiterated its commitment to include the Associations and providers in future PDPM discussions.
2023-24 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 in the near future.
MDS Audits – OMIG reported the 2018 MDS audits for all statewide regions are complete. OMIG is reviewing subsequent MDS data prior to commencing 2019 field work.
NYSHFA | NYSCAL CONTACT:
Carl J. Pucci
Financial Consultant
518-462-4800 x36
