Impact of ATB Cut Coming in Medicaid Cycle 2219
As we have communicated to members previously, the impact of the 1 percent across-the-board (ATB) cut will be first included in Medicaid payment cycle 2219 (check date of March 2nd, release date of March 18th). A letter distributed by the Department of Health (DOH) on Feb. 24th provides formal notification of this to Medicaid providers. For providers, the cut does not involve a rate re-issuance; it simply reduces payments for services provided on or after Jan. 1, 2020 by 1 percent. Managed care and Managed Long Term Care (MLTC) plans are experiencing the cut as a rate revision.
The cut is imposed on almost all Medicaid providers and plans, including home care providers, Assisted Living Programs (ALPs), nursing homes, and MLTC plans (Programs of All-Inclusive Care for the Elderly (PACE), Medicaid Advantage Plus (MAP), and Partially Capitated). Hospice providers are not subject to the cut.
The section of the DOH notice that speaks to the payment reduction timing is copied below, and the entire notice, which contains a listing of payments subject to the cut as well as those exempt, is available here. Member providers should be prepared to see the negative adjustment in payment cycle 2219 identified as an “FC2” recoupment equaling 1 percent of Medicaid payments for services retroactive to Jan. 1st. The cut is scheduled to continue indefinitely and “impacts dates of service on or after January 1, 2020, through March 31, 2020, and each State Fiscal Year thereafter.”
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841
Excerpt from DOH Notice: Effective for dates of service on or after January 1, 2020, through March 31, 2020, and each State Fiscal Year thereafter, all non-exempt Department of Health state funds Medicaid payments will be uniformly reduced by 1%. For services subject to the 1% reduction, all fee-for service payments will receive a decrease to Medicaid checks and/or Electronic Funds Transfers for dates of services on or after January 1, 2020. Conversely, managed care payments to health plans will be reduced through a 1% reduction to premium rates effective January 1, 2020. Remittances will reflect the 1% reduction (appearing as an “FC2” recoupment) starting in cycle 2219, which has a check release date of 3/18/2020.