DOH Posts Initial January and April 2020 Nursing Home Medicaid Rates
The Department of Health (DOH) has posted initial January and April 2020 Medicaid rates. The Jan. 1, 2020 rate updates the capital component and should reflect correction requests made through the attestation process. The operating rate is not updated at this point and still reflects the case mix index (CMI) from the previous rate (i.e., July 1, 2019). When DOH completes the CMI calculations based on the recent roster verification process, the Department will issue updated rates.
The April 2, 2020 rate is the same but incorporates the 5 percent cut to the capital component enacted in this year’s State Budget. The reduction is reflected as a negative adjustment on line 13 of the first page of the rate sheet. Note that line 13 also contains the 1.5 percent “across the board investment” (which began in November 2018 and remains unchanged), any facility-specific minimum wage adjustment, and the 2 percent quality penalty for those facilities subject to that reduction. The rate also reflects the elimination of residual equity payments, which impacts for-profit homes.
Members should see payment adjustments reflecting both the January and April initial rates in Medicaid payment cycle 2243, with a check release date of Sept. 2nd. We remind members to navigate to the Healthcare Financial Data Gateway section of the Health Commerce System (HCS) to access the rate sheets. The accompanying Dear Administrator Letter (DAL) is available here.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841