DOH Updates Nursing Home Medicaid Rates

The Department of Health (DOH) posted nursing home 2012 Cash Receipts Assessment (CRA) reconciliation calculation sheets as well as Jan. 1, 2015 Medicaid rate sheets for nursing homes and Adult Day Health Care (ADHC) Programs on the Health Commerce System (HCS). The DOH instructions for accessing them are copied below. The Dear Administrator Letter (DAL) that accompanied the CRA calculations sheets is available here. The Jan. 1, 2015 Rates DAL is here. Both are available on the HCS.

Rate adjustments based on these update should be reflected in Medicaid payment cycle 1959, which has a check date of Mon., March 9 and a release date of Wed., March 25. Please note that the case mix adjustments for these rates are still based on January 2014 MDS data, meaning that a final update to update to July 2014 MDS data will be forthcoming.   

When DOH begins paying the Jan. 1, 2015 rate, they will also update the cash receipts assessment reimbursement amount facilities receive when they bill rate code 3836 to the 2012 reconciled cash receipts assessment per diem amount shown on the CRA reconciliation calculation sheet. 

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

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Assessment Calculation Sheet:  

1. Log into the HCS at  https://commerce.health.state.ny.us/hcs
2. Health Commerce System Welcome Page - select "NH Cash Receipts Assessment" under the heading "My Applications"
3. "2012 Cash Receipts Assessment Reconciliation” the drop-down list under "Nursing Home Rates Selection List"
4. Identify your facility in the drop-down list under "Nursing Home Selection List" and then select "SHOW REPORTS"

2015 Nursing Home and ADHC Rate Sheets:   

1. Log into the HCS at  https://commerce.health.state.ny.us/hcs
2. Under the MY APPLICATIONS heading, find “NH Rate Sheets 4/2009-Forward"
3. Select your facility.
4. Select NH 2015 Initial January – The DAL and all rate sheets are available from this link.