DOH Posts Nursing Home Medicaid Rate Details
(July 8, 2025) The Department of Health (DOH) has posted a spreadsheet detailing the individual adjustments that comprise the figure shown on the “Misc. Per Diem Adjustments” line of the January 2025 nursing home Medicaid rate sheet. These include 2025 minimum wage funding, continuing rate increases (1.5 percent enacted in 2018, 1 percent enacted in 2022, and 7.5 percent enacted in 2023) and the 2 percent quality penalty. The information is available for viewing or download here. Payment updates to reflect the new rates, retroactive to Jan. 1, 2025, will be included in Medicaid payment cycle 2499, which is scheduled to be released on July 30th. The associated Dear Administrator Letter (DAL) is available here.
Members should keep in mind that Medicaid cost reports, along with required certifications, are due July 31st. Given the possibility of vacation absences, we urge members to make sure that those who will need to certify the report have the necessary Health Commerce System (HCS) permissions in place to ensure timely electronic certification of the report.
Additionally, DOH has filed Medicaid State Plan Amendments (SPAs) regarding funding increases enacted in the 2025-26 State Budget for nursing homes as well as Medicaid Assisted Living Programs (ALPs), hospices, and Adult Day Health Care (ADHC) programs. While the fate of any Medicaid increases will depend on future executive and legislative decisions to address the material reductions to the State's federal Medicaid funding stemming from the recently signed federal reconciliation legislation, we are pleased to see the State take the necessary procedural steps to facilitate that funding. If the funding does go forward, $60 million would be distributed based on revenue, while the rest would be distributed based on days.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841