DOH Provides Several Rate Updates
January 2022 Rates. Nursing home providers should soon hear that their January 2022 Medicaid rates are being updated to reflect 2022 capital. Members may recall that due to various delays in completing the 2022 capital calculations, the Department of Health (DOH) split the January 2022 rate update into two phases: the first phase was an update to the operating component, with the second phase coming soon as the update to the capital rate. The capital rates are now complete and approved, meaning that providers should be seeing their capital rate sheets shortly and that DOH will be circulating the Medicaid rate cycle in which the capital payment update retroactive to January 2022 will be made. At the same time, DOH will be issuing a January 2022 nursing home benchmark rate list used by Medicaid managed care plans.
MDS Certifications. DOH reminds that this Fri., Aug. 12th, is the due date for notarized certification forms that attest to the veracity of the Minimum Data Set (MDS) review. As of Aug. 9th, DOH reported that several handfuls of homes had not completed the MDS review process, but that of those that had, 429 had submitted their certifications. We urge members to make sure to email their certifications to the *NEW* email address established for this process, NFMDS@health.ny.gov, and to do so at their first opportunity, but no later than Fri., Aug. 12th. Please note that DOH has established this new email address starting this cycle and that some have reported that the previous address is no longer working.
2021 Cost Reports. Despite two extensions to the original due date, DOH reports that a number of homes did not submit their cost report and certification by the final Aug. 8th deadline. DOH is in the process of contacting those providers.
OMIG MDS Audits. The Office of the Medicaid Inspector General (OMIG) reports that it is getting close to completing the 2017 MDS audit reports, with 46 providers awaiting re-RUGing based on audit findings. OMIG staff expect to begin audits of 2018 MDS assessments in the fall.
ALP Corrections. As reported elsewhere in Intelligence, DOH issued updated April 2022 ALP rates, which included the 1 percent Medicaid increase enacted in this year’s State Budget. In addition, the Department has handled another handful of ALP minimum wage corrections, which are scheduled to be reflected in Medicaid cycle #2347, with checks released Aug. 31st.
NHQI Score Review. The State is awaiting federal approval of the 2021 Nursing Home Quality Initiative (NHQI) (2020 measurement year, 2021 payment year). Once approval is received, DOH expects to post score sheets for provider review fairly quickly.
Bonus Payments. The Medicaid Fee-for Service Rate Setting Bureau indicates that for consistency’s sake, the Department is centralizing decisions and answers regarding health care worker bonuses. Their Bureau had no information to provide on this topic, or on staffing or staffing funding issues.
Contact: Darius Kirstein, dkirstein@ledingageny.org, 518-867-8841