Agreement Reached on Universal Settlement

An agreement has been reached between the State of New York and legal counsels representing nursing homes on the terms of an $850 million universal settlement of most Medicaid rate appeals and reimbursement litigation. The agreement is subject to ratification by nursing homes, and the State is seeking to have responses from all facilities by Jan. 9, 2015. 

A group comprised primarily of legal counsels representing nursing homes in various pending Medicaid rate litigation matters has concluded negotiations with officials from the Department of Health (DOH), Governor's office, Division of the Budget and Office of the Medicaid Inspector General on the terms of a proposed universal settlement of outstanding nursing home litigation and rate appeals.

Associations representing nursing homes are working together and will shortly distribute by e-mail the term sheet along with facility payment amounts and other explanatory materials. The State has signaled that the window for facilities to respond as to their participation will be very narrow, with responses due Jan. 9, 2015. With this timeframe in mind, the undersigned Associations will be holding an audio conference tentatively scheduled for Mon., Dec. 29 to review the settlement agreement terms with member facilities and respond to questions. 

The overall settlement would provide $850 million in additional payments to nursing homes over a five-year period. In exchange for these payments, nursing homes in the State would have to agree to drop nearly all pending lawsuits and rate appeals involving rates in effect prior to Jan. 1, 2012 (i.e., the implementation of statewide pricing), as well as some more recent rate matters, with certain exceptions.

Please be on the lookout for further communications today or tomorrow with settlement materials and details regarding Monday's call.

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