Nursing Home Appeals Review Deadline Further Extended to Jan. 16th
The Department of Health (DOH) has extended the deadline for nursing homes to review Medicaid rate appeals covering 2009 through 2021 to Jan. 16th. The previous deadline was Jan. 8th. Members will recall that DOH is implementing the rate appeal “attestation exercise” with the goal of clearing outstanding Medicaid appeals as far back as 2009. Homes with outstanding appeals are asked to review a listing of appeals provided by DOH in an Excel workbook and to provide the requested information on the “Residential Health Care Facility Open Appeals Impact Form” tab of that Excel workbook for each appeal listed for their facility. The appeals workbook along with the associated Dear Administrator Letter (DAL), attestation, and instructional webinar are posted here (click on “2023 Appeals Processing Webinar” to access individual files).
In a Dec. 18th email, DOH provided guidance to new owners of homes that have changed ownership since 2009 on reviewing appeals that were originally filed by the prior owner. New owners who have sufficient information to attest to the contents of these appeals are requested to do so. Those who do not have sufficient information regarding an appeal and are unable to partner with prior owners to review and attest to those appeals may identify such appeals in the workbook simply as “Prior Ownership.”
In this scenario, the provider should enter the appeal number in the appropriate column and in the “Comments” column enter “Prior Ownership.” DOH will consider this to be an attestation to the existence of the appeal, but not an attestation to the accuracy of the contents of the appeal. Appeals filed under prior ownership for which the accuracy of the contents of the appeal cannot be attested will be addressed following the completion of the Statewide Appeals Processing Project. DOH is fielding questions on the process at nfrates@health.ny.gov.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841