DOH Posts 2 Percent Supplemental Back-Up

Although the Department of Health (DOH) does not seem to have pushed out notifications or Dear Administrator Letters (DALs) for rate adjustments and supplemental payments that are scheduled to be included in Medicaid checks released this week, the Department has posted DALs as well as back-up calculations on its website. Medicaid payment cycle 2362 should contain Medicaid rate adjustments retroactive to July 1, 2022 as well as the 2 percent supplemental payments that represent reinvestment of funds generated by the 0.8 percent non-reimbursable assessment. For prequalified facilities, the cycle will also include Advanced Training Initiative (ATI) funding.

A copy of the DAL associated with the July 2022 rates is available here, and rate sheets are posted on the Healthcare Financial Data Gateway section of the Health Commerce System (HCS). A copy of the DAL associated with the 2 percent supplemental payment is posted here, and the back-up calculations are available here under the “Nursing Home Quality Pool (NHQP) and 2% Supplemental Payment” section. Note that there are two worksheets – one with the calculation for this year’s 2 percent payment and the other showing this year’s total amount along with last year’s reconciliation amount (from estimated to actual Medicaid days). When reviewing the spreadsheets, homes with specialty beds should scroll down to the end of the list where specialty unit allocations are listed separately.

Although not specified in the 2 percent supplemental DAL, members who have outstanding Medicaid liabilities may have their cycle 2362 payment intercepted, have their supplemental payment amount reduced by any outstanding Medicaid liability, and be issued a paper check.

Unlike prior years, the supplemental payment is NOT bundled with the Nursing Home Quality Initiative (NHQI) payment adjustment. That was delayed due to later-than-usual Centers for Medicare and Medicaid Services (CMS) approval, but is now approved and making its way toward the payment system. We are grateful that DOH went forward with releasing the supplemental payments and did not wait for the NHQI adjustment to be finalized.

Please contact us with questions or reach out to nfrates@health.ny.gov.

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