2018 Medicaid Rates on Track for January

All but 20 homes in the state have submitted attestations accepting or correcting their draft 2018 Medicaid capital rate calculation issued by the Department of Health (DOH) in October. Of all the correction requests the Department received, only 17 were not accepted. At a meeting with LeadingAge NY and other associations, DOH reported on these and other encouraging indicators that the 2018 nursing home Medicaid rates are on schedule to be issued closer to the start of the year than in any previous year. They will include an updated, July 2017-based case mix index. In a managed care environment, up-to-date rates are important to both homes and plans to minimize the need for retroactive adjustments.

Those who have yet to submit their attestations should do so as soon as possible. Homes whose attestations are not received, or who file late correction requests that DOH is unable to review by the end of November, will face delays in having the 2018 capital reflected in their Medicaid rate. The link to the attestation form and the Dear Administrator Letter that accompanied it is available here. Members who are still reviewing their capital rate or do not plan to submit the attestation should send a note to DOH at nfrates@health.ny.gov.

The data from the survey collecting minimum wage data for contract workers has been combined with the data from the survey that collected employee wage information. DOH is finalizing the minimum wage adjustments that will appear on the Jan. 1, 2018 Medicaid rate sheet. While the methodology for calculating the facility-specific figure does include a regional adjustment, providers should see an amount that closely approximates what they reported on their surveys. The minimum wage adjustment is meant to cover the additional cost of increasing wages that are below the new 2018 minimum wage rates to the minimum. Please note that this amount will be additive to the amount of the minimum wage adjustment on the 2017 rate sheet.

DOH reminded that the state intends to reconcile any minimum wage funding provided to the actual, documented need. This will likely be done by a dedicated survey that homes will be asked to complete in the spring. Details are still being finalized, but we recommend that members track and document the use of minimum wage dollars to be prepared for the reconciliation.

DOH has issued updated July 2014 and January 2015 Medicaid rates for homes that had MDS audit findings for those time periods. The update includes removal of case mix constraints for those homes that were subject to constraint. Rate sheets reflecting the updates have been posted to the Health Commerce System (HCS), and homes subject to a negative adjustment should have received a notice from eMedNY indicating that interest will begin accruing on Jan. 8, 2018 if the balance is not paid by then. Positive rate adjustments should have been reflected in Medicaid payment cycle 2097. Audit finding appeals are still being finalized for several homes, which should see no rate adjustment until the appeal process is complete.

Advanced Training Initiative funding for State Fiscal Year 2017-18 was appropriated, and DOH is currently working on calculating staff retention rates, which are instrumental in determining eligibility for the funding. When the calculations are completed, we expect to meet with DOH to discuss eligibility, payment method and timing, as well as available training programs.

In response to concerns regarding the phase-out of Fox Pro recoupment reports, DOH is working to develop a new report with similar information that would be available through eMedNY. It is not clear when the new reports will be available, but we will keep members apprised. The reports were discontinued because the software required to produce them was no longer supported by technology upgrades. While providers do receive weekly remittance reports that have information for that cycle’s payments and recoupments, DOH understands that they provide insufficient detail.

Public homes have been notified of their first installment of 2017-18 Intergovernmental Transfer Payment (IGT), and counties are required to make the associated transfer by the end of November. The second of two payments for the 2017-18 year is expected in March.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841