CHHA Episodic Payment Update

The Department of Health (DOH) will post a Dear Administrator Letter (DAL) on the revised Episodic Payment System (EPS) rates effective April 1, 2015. It can be found in your HCS account under "CHHA Rate Sheets." As we previously reported, the rates are being calculated according to Article 3614.13 of the Public Health Law. The DAL states, "the rates will reflect an interim percentage adjustment to the current 2009 base year episodic payment rates, as the initial step for implementation of the final rebasing of the EPS in accordance with Section 3614.13(b) of the PHL."

According to DOH, "this interim adjustment will help to avoid the significant retroactive recoupment from agencies and based upon the latest available statewide CHHA episodic utilization, a statewide interim adjustment of a negative 12 percent to the current 2009 base rates achieves the estimated $30 million annual savings." The rates effective April 1, 2015 will reflect the negative 12 percent reduction to the 108 case mix adjusted payment rates for those patients over 18 years old under EPS. The revised rates are anticipated to receive DOH and DOB approval and then forwarded onto eMedNY around Fri., May 15, 2015.

DOH will continue to work on the finalizing episodic payment rates on the 2013 claims data and anticipates the final 2013 rebasing will be implemented around October 2015.

If you have questions or require additional information please contact DOH staff, Tim Casey or Charles Tobey at 518-473-4421.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871