NH Medicaid Rates Update

The Department of Health (DOH) reports that four nursing home Medicaid rate updates are in varying stages of review. The 2013 nursing home quality initiative (i.e., quality pool) adjustments to 2013 rates are with the Division of the Budget (DOB) with the hope that they will be forwarded this week to e-MedNY. Reconciliation of 2012 cash receipts assessment payments are being sent to DOB this week, followed closely by Jan. 1, 2015 initial Medicaid rates reflecting a July 2014 Case Mix Index (CMI). Based on this timing, homes should see the impact of these updates in Medicaid checks released in February.        

OMIG and DOH have also finalized MDS audits related to rates effective July through December of 2012, and January through June 2013 and calculated any resulting adjustments. These adjustments, as well as the release of the five percent CMI constraint on these rates, should be forwarded to DOB for approval at the end of the month.    

We will advise members as soon as payment cycles for these rate updates are known.

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