DOH Monthly Briefing – May 2021

DOH held its Monthly Briefing earlier today. The following summarizes the topics discussed:

Budget Items

• Nursing Homes Reform – internal conversations continue regarding various nursing home reform issues contained in the 2021/22 Executive Budget. Further guidance will be issued.
• July 2021 Case Mix – DOH will be issuing regulations for its 6-month rolling MDS collection period (Oct 2020 – Mar 2021) utilizing all MDS data points. As you are aware, DOH has been advancing this initiative for some time and this rolling process will replace the historical 92-day look-back period. As such, NYSHFA has continuously stressed to our members that they treat each MDS as if they were in the historical reimbursement “catchment period.” DOH will issue a formal notice of this change to providers prior to July 1, 2021.

January 2021 Case Mix

The current MDS certifications are due this Friday, May 14, 2021. A large number of providers have yet to certify their MDS submissions. A digital certification is needed to set the Medicaid rates and should be submitted to MDSBRHCR@health.ny.gov. DOH will break the rates into two separate packages, if needed, in order to process the 1/1/21 case mix adjustment. Facilities who are not certified may fall into the second rate package and could face a delay in their 1/1/21 revised rates.

Additional 1% Restoration

DOH continues work to advance the State Plan Amendment for the additional 1% restoration. A financing package has been sent to DOB for their approval. Upon approval, funding would be via a lump-sum payment vs. rate adjustment. NYSHFA will provide further details once DOH finalizes the payment methodology.

2020 RHCF Deadline

DOH anticipates release of the RHCF software within the next two weeks and will provide a 60-day response time for filing. Further details via a DAL will be forthcoming.

OMIG MDS Audits

OMIG confirmed that the 2016 MDS audits are now complete. OMIG has a majority of 2017 MDS audits currently in fieldwork and nearing their exit conferences.

ADHC – 2020 Reporting Requirements

With ADHC closures on 3/18/20 due to COVID, NYSHFA requested guidance on the 2020 census reporting requirement. DOH will review internally and respond at a later date.

NYSHFA/NYSCAL CONTACT:

Carl J. Pucci
Chief Financial Officer
518-462-4800 x36