DOH Updates ALP Rates
The Department of Health (DOH) has issued 2020 Medicaid rates for Assisted Living Programs (ALPs) to incorporate minimum wage adjustments based on survey information submitted by providers. The listing of program-specific rates by Resource Utilization Group (RUG) category is posted on the DOH website here (or can be downloaded as a spreadsheet here). Please note that only programs with minimum wage adjustments to their rates appear on the list. The 2020 rates for programs that reported no minimum wage costs on the survey should remain unchanged.
At the same time, DOH has recalculated minimum wage adjustments reflected in 2017 and 2018 ALP rates from a regional calculation to a program-specific calculation based on submitted surveys for the respective years. The revised rate lists are posted on the DOH website (2017 is here; 2018 here). The shift from a regional to a program-specific calculation means that some providers will see positive adjustments, while others will experience reductions to their rates. Please note that this update to 2017 and 2018 rates is a correction and that reconciliation of minimum wage funding that a provider receives to the funding needed remains outstanding.
Payment adjustments related to these rate updates should be in cycle 2242 (checks dated Aug. 10th and scheduled to be released on Aug. 26th). While positive retroactive adjustments for 2017 and 2018 should not be impacted, please keep in mind that positive adjustments for service dates between Jan. 1st and April 1, 2020 will be reduced by 1 percent and 1.5 percent for service dates on and after April 2nd. The DOH notice is copied below.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841 or Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8383
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Dear Administrator:
This letter provides you with information regarding your Assisted Living Program (ALP) Medicaid reimbursement rates effective January 1, 2017, January 1, 2018 and January 1, 2020. The formula on which these rates are based was promulgated in accordance with Title 10, Part 86-7 of the Commissioner’s Administrative Rules and Regulations. These rates are available on the NYS DOH public website.
The ALP Rates are based on fifty percent of the 1992 regional nursing home average rate for the sixteen ALP regions. Additionally, minimum wage increases have been incorporated into these rates based on survey data that was submitted and attested to by ALPs.
Included is an adjustment to the 2017 ALP rates due to a correction to the original 2017 minimum wage calculation.
Included is an adjustment to the 2018 ALP rates due to a correction to the original 2018 minimum wage calculation.
The 2020 ALP rates incorporate a minimum age adjustment based on the 2020 minimum wage survey data submitted.
The payment for the January 1, 2017, 2018 and 2020 rates will be made in cycle 2242, check release date August 26, 2020. If you have any questions regarding the information above, please send an email to ALP-Rates@health.ny.gov and Russ Smith will respond to your inquiry.
Sincerely,
Laura Rosenthal, Director
Bureau of Residential Health Care Reimbursement
Division of Finance and Rate Setting
Office of Health Insurance Programs