Nursing Home Medicaid Payment Update

Of the several Medicaid rate adjustments DOH is preparing, the one nursing home providers are likely to see first is the 2011 cash receipts assessment reconciliation.  The calculations are currently under review by the Division of the Budget (DOB).   DOH expects to make rate adjustments based on the reconciliation in June.  Although the statewide impact is a net gain for providers, individual homes may see positive or negative adjustments based on their individual circumstances.  Rate adjustments to reconcile the 2012 cash receipts assessment are expected in August.    

DOH is preparing to reissue January 2014 Medicaid rate sheets to reflect the July 2013 roster-based Case Mix Index (CMI) within a month.  The rates are currently being reviewed by DOB.  Pursuant to regulations, homes whose CMI changes by more than five percent since the previous roster submission will be held to a five percent change pending MDS audit.

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