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DOH Posts January 2024 Nursing Home Medicaid Rates

(June 25, 2024) The Department of Health (DOH) has posted January 2024 Medicaid rates on the Health Commerce System (HCS). The new rate sheets update the capital component and several of the add-ons to the rate. Members will recall that no update is being made to the case mix adjustment, which is frozen pending the implementation of a replacement case mix methodology. To access the rate sheets, navigate to the Healthcare Financial Data Gateway section on the HCS and select “2024 Initial NH Rates.” The associated Dear Administrator Letter (DAL) is available here. Payment of the new rates retroactive to Jan. 1, 2024 will be reflected in Medicaid payment cycle 2445, scheduled for release on July 17th.

The DAL indicates that the rates reflect approved capital correction requests that the Department received during the capital preview period. We recommend that members examine their capital component for accuracy, including any shared savings calculation. Apart from capital, changes to the rate should be limited to adjustments that are shown on line 13 (“Misc. per-diem adjustments”) on the first page of the rate sheet. Medicaid rate increases enacted in the past few years have been incorporated into the rate as miscellaneous adjustments. DOH arrives at these adjustments by multiplying the rate less the capital component by the specified percentage. These add-ons are recalculated annually in conjunction with January rates. Adjustments that are being updated include the 1.5 percent increase in place since November 2018, the 1.0 percent increase effective April 2022, and the 6.5 percent increase effective April 2023. Most members will see a nominal change that should approximate 9 percent of the difference between the January 2023 and July 2023 operating rate. The Department has posted the individual adjustments that comprise the figure shown on line 13 of the rate sheet here.

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