Medicaid Rate Increase Coming in Early November
The Department of Health (DOH) has announced that the state has agreed to release funding for a Medicaid rate increase before formal federal approval of the increase is received. The 6.5 percent adjustment to nursing home, Medicaid Assisted Living Program (ALP) and Adult Day Health Care Program (ADHC) rates will be reflected in Medicaid payment cycle 2408 that is scheduled for release on Nov. 2nd. The increase is being made pursuant to provisions included in the 2023-24 State Budget and is retroactive to April 1, 2023.
Members will recall that for nursing homes and ADHC Programs, the state submitted a Medicaid State Plan Amendment (SPA) to the Centers for Medicare and Medicaid Services (CMS) requesting a 7.5 percent increase. We have been stressing the dire need for the rate increases enacted in April to be paid and have urged the state to release at least a portion of the funding prior to formal CMS approval. We are pleased that the State has taken this step. Pending federal approval of the full 7.5 percent increase for nursing homes and ADHC programs, and contingent on Department of Budget (DOB) approval, we expect the additional 1 percent state-share to be paid in the future. For ALPs, the 6.5 percent represents the full increase enacted in the State Budget.
ALPs can download a spreadsheet with the new rates by clicking here and selecting “Current Rates” and then clicking on “April 2023 ALPS 6.5% Enhancement”. Nursing home and ADHC back-up documents have not yet been posted but the Dear Administrator Letter (DAL) announcing the increase is here. The ALP DAL is here.
We remind nursing home members that DOH recently processed and posted July 2023 Medicaid rates. Payment adjustments retroactive to July 1, 2023 will be in Medicaid payment cycle 2406, which has a check release date of Oct. 18th. The associated Dear Administrator Letter (DAL) is available here. Note that the 6.5 percent rate increase will NOT be reflected in the July rate adjustments released in cycle 2406. Rate adjustments to reflect the 6.5 percent increase retroactive to April 1, 2023 will be in cycle 2408.
Members are encouraged to review their rate documents for accuracy and to contact us with any questions or concerns.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841