Cash Receipts Assessment Reconciliation Do-Over
The nursing home Medicaid payment adjustments that were made in Medicaid payment cycle 2057 to reconcile the 2015 Cash Receipts Assessment were inaccurate. To correct the problem, the Department of Health (DOH) will reverse these adjustments in Medicaid payment cycle 2059. The corrected adjustments will be included in Medicaid payment 2061, which has a check release date of March 8, 2017. The DOH notification regarding this issue is copied below.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841
Dear Administrator:
The 2015 Cash Receipts Reconciliation (CRA) calculation has been completed and approved for payment. The Department has determined that an error occurred in the per diem loading process which resulted in the assignment of incorrect reconciliation per diems. This error became apparent with the processing of Cycle 2057. The error has led to both overpayment and to several recoupments. The Department is working through the eMedNY system to correct all of the per diems and reprocess the 2015 claim with the appropriate reconciled per diem amounts. The following outlines the process:
Cycle 2057 – The incorrect 2015 CRA reconciliation amounts were included in Medicaid payments.
Cycle 2059 – ALL facilities are reversed and set back to the original, pre reconciliation per diem and any A/R balances created in cycle 2057 will be recouped at 100%
Cycle 2061 – The correct 2015 CRA reconciliation amounts will be included in Medicaid payments.
Using this method, it will be possible for the Department to analyze the over payments and recoupments which need to be negated either through the reprocessing of claims or through a collection process. Facilities will not be required to take any actions as the corrections work through the system. The final CRA reconciliation calculation are expected to be available on the Health Commerce System in early February.
If you have any questions or require additional information, please contact NFRATES@health.ny.gov.