DOH Posts 2018 Medicaid Rates for Hospice, Personal Care, and CHHAs Serving Pediatric Patients

Hospice Residence and Non-Residence Rates

The Department of Health (DOH) has published the Medicaid hospice residence and non-residence rates, both of which are for the current calendar year. DOH will make the initial rate payments in Medicaid Payment Cycle 2121, with a check release date of May 2, 2018.

Click here for the Hospice Residence rate Dear Administrator Letter (DAL) and here for the published rates. Click here for the Dear Administrator Letter (DAL) for the Hospice Non-Residence rates and here for the published rates. Specific questions about the rates should be emailed to DOH at Hospice-Rates@health.ny.gov.

Personal Care Rates

DOH also recently posted the initial 2018 Medicaid fee-for-service (FFS) rates for consumer directed/personal care programs outside of New York City. The Dear Administrator Letter (DAL) accompanying the rates provides information on the statewide aggregate Administrative and General (A&G) cap, which is limited to no more than 28 percent of total costs. The A&G cap specifically for consumer directed services continues to be 18 percent. The DAL also discusses aide and training ceilings, capital costs, profit/surplus percent, the worker recruitment and retention adjustment add-on of 6.06 percent, and the rate appeals process. Payment for the Jan. 1, 2018 initial rates will be made in Medicaid Payment Cycle 2121, with a check release date of May 2, 2018. For rate questions, please email PersonalCare-Rates@health.ny.gov. For the published 2018 personal care rates, click here.

CHHA Pediatric Medicaid Rates

DOH has also posted the initial 2018 Medicaid FFS rates for Certified Home Health Agencies (CHHAs) serving pediatric patients (under 18 years of age). This also includes New York City wage parity, workforce add-on monies, and minimum wage adjustments.

The initial 2018 CHHA rates also include the 3 percent adjustment for purposes of improving recruitment and retention of non-supervisory 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 ($100 million statewide).

According to the DAL, the 2018 rates no longer include an add-on for Fair Labor Standards Act (FLSA) costs. This uniform additional FLSA add-on amount should now be captured with the expenses of the cost report. However, the 2017 recruitment and retention percentage add-on of 8.16 percent includes the adjustment to reimburse non-New York City personal care providers for the uniform additional hourly FLSA add-on amount as determined in the FLSA adjustment rates effective Oct. 13, 2015.

Payment for the Jan. 1, 2018 initial rates will be made in Medicaid Payment Cycle 2121, with a check release date of May 2, 2018. For the DAL and rate sheet, please access the Health Commerce System (HCS). For rate questions, email PersonalCare-Rates@health.ny.gov.

Contact: Meg Carr Everett, meverett@leadingageny.org, 518-867-8871