Nursing Home Transition and Diversion and Traumatic Brain Injury Waiver Updates

Last week LeadingAge NY confirmed with the Department of Health (DOH) that the Nursing Home Transition and Diversion (NHTD) rates for some of the waiver services were increased by three percent. This is similair to what we reported in December 2014 for the Traumatic Brain Injury (TBI) waiver. According to DOH the NHTD rates were loaded into eMedNY around July 13.  The increases are for those waiver services where the rate amounts are fixed. As an example, A Home and Community Support Services (HCSS) nursing visit would increase from $60.00 to $61.80. The rate increase would not include some services such as moving or environmental modifications (E-mods) where providers are reimbursed for the final cost of the project.

It is expected the Apr. 2015 TBI rate increases to loaded into eMedNY around July 20.

It is our undertanding the Centers for Medicare and Medicaid Services (CMS) has yet to approve the rate increases, therefore this increase represents the State share. LeadingAge NY continues its advocacy with CMS supporting the rate increases for both waiver programs.

As a reminder this follows DOH extending both the Jan. 2016 NHTD and the Apr. 2016 TBI effective dates to Jan. 2017 for transitioning these programs to mandatory Medicaid managed care (mainstream and managed long term care).”

We will keep you posted as we receive any additional information.

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