Assessment Reconciliation Adjustments Scheduled

The Department of Health (DOH) 2018 nursing home assessment reconciliation calculations have been approved by the Division of the Budget (DOB) and sent to eMedNY for payment. Providers should be seeing the adjustment (up or down based on an individual organization’s circumstances) in Medicaid payment cycle 2215, currently scheduled to be released in the first week of February. DOH intends to post the final backup calculations on the DOH Medicaid reimbursement website shortly, but members can access the draft calculations here.

We also continue to remind nursing home providers to reserve sufficient resources to endure two weeks without fee-for-service (FFS) Medicaid payments in the first quarter of 2020. Members will recall that to expedite the reversal of the retracted July 2019 rates, non-specialty nursing homes were removed from the two-week Medicaid payment lag. Because this resulted in homes receiving four weekly Medicaid payments over the course of two weeks, returning to the lag will require providers to endure two weeks when no payments are made.

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