LeadingAge NY Advocating for Timely Quality and IGT Payments

LeadingAge New York is continuing its advocacy for implementation of the Nursing Home Quality Initiative (NHQI) payment adjustments, and for movement on the Intergovernmental Transfer (IGT) payments to publicly-sponsored homes for 2014 and subsequent periods.

In a May 31, 2016 letter to State Health Commissioner Howard Zucker, LeadingAge NY and the Continuing Care Leadership Coalition (CCLC) urged the Department of Health (DOH) to take the necessary steps to implement the NHQI authorized in Section 2808 of the Public Health Law. The letter reiterates concerns that the protracted delays in making the associated payment adjustments have created considerable uncertainty for nursing home providers and managed care plans. Payment adjustments for 2013-15 have yet to be made.

LeadingAge NY has also asked for a meeting with DOH to discuss the current status of IGT payments to public nursing homes. Nursing homes operated by counties and New York City are concerned that the IGT payments for 2014 and 2015 have not been made. The Centers for Medicare and Medicaid Services (CMS) must approve the relevant Medicaid State Plan Amendments before these payments can be authorized. CMS has apparently had questions about the state’s calculations and assurances regarding the Medicare upper payment limit, which dictates the amount of IGT payments that can be made each year. A significant amount of federal funding is at issue for these two years, which has an important bearing on public facility and county/municipal budgets. LeadingAge NY has offered to assist DOH in advocating for CMS action on this issue.

LeadingAge NY is also interested in discussing the recently adopted federal Medicaid managed care regulations with DOH. These regulations may provide greater flexibility in future years for making supplemental payments to nursing homes, such as IGTs, in a managed care context.

LeadingAge NY will keep members updated on the status of these advocacy efforts.

Contact: Dan Heim, dheim@leadingageny.org, 518-867-8383, ext. 128