DOH Posts Provider-Specific Funding Figures

(Oct. 8, 2024) As reported last week, the Department of Health (DOH) notified nursing homes along with adult day health care (ADHC), Hospice and Medicaid Assisted Living Programs (ALPs) that the state share of additional Medicaid funding is headed their way. These are the provider types that were included in the $300M dollars of one-time funding that was allocated in this year’s State Budget. Those who are on the 2-week Medicaid lag should see this lump sum payment in Medicaid payment cycle 2458 which is scheduled for release on Oct.16^th.

DOH has now posted the Dear Administrator letters along with a listing of the provider-specific amounts on their website. Nursing homes, ADHC programs and hospices should receive a total (state and federal) amount of $13.55 per Medicaid day billed in 2022. The state share, or 50 percent of the total, is being released now, so these provider types should receive $6.78 per 2022 billed Medicaid day next week, and another $6.78 in federal share per 2022 Medicaid day once the state’s Medicaid State Plan Amendment (SPA) is approved. 

For Medicaid Assisted Living Programs or ALPs, the full amount is $4.22 per 2022 billed Medicaid day. The distribution that ALP providers should receive on Oct.16th is a lump sum payment equaling $2.11 per 2022 Medicaid day, with an additional $2.11 once federal approval is received.

The provider-specific listings for those that are receiving funding are available at the following links:

• Nursing Home and Specialty NH Units: https://www.health.ny.gov/facilities/long_term_care/reimbursement/nhr/
• Adult Day Healthcare: https://www.health.ny.gov/facilities/long_term_care/reimbursement/adhc/
• Assisted Living Program: https://www.health.ny.gov/facilities/long_term_care/reimbursement/alp/
• Hospice: https://www.health.ny.gov/facilities/long_term_care/reimbursement/hospice/

Please note that the distributions may not tie back to Medicaid days reported on 2022 Medicaid cost reports since the definition of “billed Medicaid days” that DOH appears to be using is limited to those days billed directly through fee-for-service Medicaid.  For nursing homes, that would exclude Medicaid managed care and hospice days. 

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