DOH Monthly Briefing – June 2024
DOH held its Monthly Briefing earlier today. The following summarizes the topics discussed:
Case Mix Freeze / PDPM update
DOH acknowledged the importance of the 10/2023 assessment changes related to PDPM. 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 PDPM case mix methodology is developed.
DOH is undergoing preliminary stage work and has contracted with Myers & Stauffer to provide data guidance. No timeframes for implementation have been released to date. DOH reiterated its commitment to include the Associations in a collaborative effort to transition to PDPM.
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.
2022 Nursing Home Quality Pool (NHQI)
The 2022 NHQI will be processed in Medicaid cycle #2444 (check release date 7/10/24). DOH will recoup existing Provider liabilities, as in past practice, at 15% per week. The website is being updated with final NHQI score sheets. NYSHFA has also requested a facility-specific impact schedule.
2023 RHCF Software Timeline
DOH has just released the 2023 RHCF software (DAL attached). The standard 60 days for RHCF filing will be in effect, with a reporting deadline of 8/19/24.
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, which includes the 2024 minimum wage adjustment.
- Capital Component: The capital component of the 2024 notice rates are based upon the facility’s 2022 cost report, and subsequent approved capital attestations.
The initial notice rates have been approved and the information is being loaded into the rate-setting system. A DAL is forthcoming.
4/1/24 Rates
The 4/1/24 rates are still under development prior to executive review. DOH noted that the methods of payment of the approved Medicaid rate increase are still to be determined per the budget statute.
2022 CRA Reconciliation
Is currently under Executive review.
2023/24 Enhanced ATI
Is currently under Executive review.
July 2023 Benchmark Rates
DOH anticipates loading the 2023 Benchmark rates to its website within the next few weeks.
Capital Rates /Appeal Process
The in-house 2023 appeals (including historic appeals from 2009) are in process and being forwarded to the Executive for review and finalization.
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 fieldwork and anticipates auditing approximately 260 facilities statewide. Initial audit notifications in the Capital Region were recently sent.
NYSHFA | NYSCAL CONTACT:
Carl J. Pucci
Financial Consultant
518-462-4800
