CHHA 2015 Hotline Rates for Pediatric Patients

The Department of Health (DOH) posted a Dear Administrator Letter (DAL) outlining the revised, non-episodic
January 1, 2015 Certified Home Health Agency (CHHA) Medicaid rates, pursuant to Part 86-1. These rates will be used to reimburse claims for patients under 18 years of age, and for patients served by a pilot program which provides services to a special needs population of medically complex and fragile children, adolescents and young disabled adults.

All other CHHA services are reimbursed on the basis of 60-day episodes of care beginning May 1, 2012.

Please log-in to the Health Commerce System (HCS) website for each non-hospital-based Certified Home Health Agency which filed a properly certified, full-year 2013 cost report where you'll find the 2015 "Hotline" rate calculation sheets. Again, these rates will be used for patients who are exempt from the Episodic Payment System (EPS). The rate calculations are located in the "Rate Publication Selection List" drop-down under the date of May 11, 2015.

The DAL includes:

Trend factor - 2014 and 2015 0% trend factor;
Worker recruitment and retention (R&R) - adjustment of 3% for those agencies that returned the signed attestation;
Worker recruitment, training and retention (RT&R) - adjustments are based on a uniform allocation percentage add-on of 4.70% for the period of January 1, 2015 through December 31, 2015, for agencies which have submitted the required attestation form;
Appeals - filing an appeal has to be done within 30 days after this DAL was posted to HCS; and
2014 Annual Cost Report- DOH plans to post the 2014 cost report software on HCS around June 1, 2015. It will be due by August 15, 2015.

Any questions related to the methodology used in the calculations should be directed to Charles Tobey or Tim Casey at (518) 473-4421.

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