DOH held its Monthly Briefing earlier today. The following summarizes the topics discussed:
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 and will be updated to include the pending 2024 minimum wage adjustment.
- Capital Component: The capital component of the 2024 notice rates are based upon the facility’s 2022 cost report, and will be updated to include approved 2024 capital attestations.
The above updates to the initial notice rates are still under executive review.
4/1/2024 Rates
The 4/1/24 rates are currently pending. DOH noted that the methods of payment of the approved 2024/25 Executive Budget Medicaid rate increase ($285M equating to 4.38%) are still to be determined per the budget statute.
Case Mix Freeze / PDPM update
DOH recognizes 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 a consulting group to provide data guidance. DOH has reiterated its commitment to include the Associations and providers in a collaborative effort to transition to PDPM once that stage of the process has been reached.
Capital Rates /Appeal Process
The in-house 2023 Capital appeals (including historic appeals from 2009) are in process and being forwarded to executive review for finalization.
July 2023 Benchmark Rates
DOH anticipates loading the 2023 Benchmark rates to its website within the next few weeks.
2023 RHCF Software Timeline
DOH will be releasing communications regarding the 2023 RHCF software release by early June. The standard 60 days for providers to file their 2023 RHCF report remains in effect.
2022 CRA Reconciliation
DOH noted that approximately one hundred facilities have CRA data issues, which will delay completion of the 2022 CRA reconciliation 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.
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.
NYSHFA | NYSCAL CONTACT:
Carl J. Pucci
Financial Consultant
518-462-4800 x36
Read More
