DOH Posts 2016 Initial Home Care Rates

The Department of Health (DOH) has posted the initial 2016 Medicaid fee-for-service (FFS) rates for Long Term Home Health Care Programs (LTHHCPs), Certified Home Health Agencies (CHHAs) for pediatric patients and Personal Care programs. All programs should review their initial rates for accuracy.

The initial CHHA, LTHHCP and Personal Care rates reflect a zero roll factor adjustment as enacted in the State budget, adopted for fiscal year 2015-16. The Personal Care Administrative and General (A&G) cap in the 2016 is limited to no more than 28 precent of the total costs reported by an agency. In the Consumer Directed Personal Assistance Program the administrative cap remains at 18 percent. In the CHHA rates for pediatric patients the A&G cap is 25.53 percent and in the LTHHCP A&G, it is at 25.75 percent.

The LTHHCP rates also include the 3 percent adjustment for recruitment and retention (R&R) of nonsupervisory home care services workers with direct patient care responsibilities, along with a 4.7 percent rate add-on adjustment for the newer Recruitment, Training and Retention (RT&R) initiative. The CHHA for pediatric patient rates that returned a signed attestation, the R&R is 3 percent along with a 4.7 percent rate add-on adjustment for the newer RT&R initiative.  

The Dear Administrator Letter (DAL) for the CHHAs 2016 initial rates for pediatric patients includes additional information on the Fair Labors Standard Act (FLSA) adjustment; FLSA survey notice; NYC wage parity; rate hotline; revisions to the 2014 annual cost report and steps to filing an appeal with a deadline of June 15, 2016. Any question should be directed to Tim Casey or Charles Tobey at (518) 473-4421.

The Dear Administrator Letter (DAL) for the LTHHCP 2016 initial rates includes additional information on the same issues of FLSA adjustment; FLSA survey notice; NYC wage parity; rate hotline; revisions to the 2014 annual cost report and steps to filing an appeal with a deadline of May 31, 2016. Any question should be directed to Russ Smith at (518) 473-4421.

The DAL for the Personal Care 2016 initial rates included the same issues as the LTHHCP and CHHA, but with additional information on criminal history record checks; capital costs; and profit/surplus percent. Any revisions to the 2014 annual cost report should be submitted by March 31, 2016. Included in the DAL are steps to filing an appeal with a deadline of May 30, 2016. Any question should be directed to Kathy Omecinsky or Tim Casey at (518) 473-4421.

Please make note of the dates for filing an appeal for each program.

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