DOH Issues Capital Preview Rates
(Nov. 5, 2024) The Department of Health (DOH) has posted January 2025 Medicaid notice rates on the Health Commerce System (HCS). As outlined in the Dear Administrator Letter (DAL) available here, both operating and capital notice rate sheets are available on the Healthcare Financial Data Gateway section of the HCS under the heading “2025 Notice Rates.” The capital rates reflect the 2025 DOH capital component calculated based on 2023 reported costs as well as the 10 percent cut enacted in the 2024-25 State Budget. There should be little, if any, change to the operating rate when compared to the current operating rate. Please note that DOH has not yet implemented the capital cut retroactive to April 1, 2024 – these rates are for 2025 and are notice rates only and as such are not subject to appeal until issued as initial rates.
Importantly, DOH is kicking off the capital rate preview process at the same time as they issue the notice rates. The preview process provides nursing homes an opportunity to review the State’s calculation of their 2025 capital rate, identify any errors or discrepancies, and request that DOH modify the rate based on a corrected calculation submitted by the provider (subject to eventual Office of the Medicaid Inspector General (OMIG) audit). Any correction request should be accompanied by a completed Capital Attestation Workbook (available for download here) as well as supporting documentation.
All providers, whether requesting a correction or verifying the accuracy of the State’s calculation, are asked to complete and submit the attestation available here by email to nfrates@health.ny.gov. Attestations and any correction requests are due by close of business on Fri., Dec. 6th. DOH also posted capital notice rates for Adult Day Health Care (ADHC) programs, but is not asking that programs attest to them at this time. A webinar recorded in 2022 explaining that year’s capital preview and attestation process that may be helpful for those unfamiliar with the procedure is available here.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841