DOH Shares Assessment Reimbursement Calculation

The Department of Health (DOH) has shared the calculations behind their draft 2018 assessment reconciliation figures. While these figures are currently being used as the basis of assessment reimbursement amounts in Medicaid fee-for-service (FFS) and appear on the most current nursing home benchmark list used by managed care plans, payment adjustments reflecting the reconciliation of actual assessment payments made and assessment reimbursement received during 2018 are still under executive review. Once the Division of the Budget (DOB) signs off, the figures will be finalized and payment adjustments for 2018 will be made. As always, the reconciliation may be positive or negative based on an individual home's circumstances.

To download the spreadsheet with the figures, click here. Because assessment reimbursement amounts have been subject to two mid-year updates in 2019, we recommend that members validate payment adjustments as well as the 2018 calculation and let DOH and us know of any discrepancies. Information on the recent assessment reimbursement updates is available here.

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