Nursing Home Medicaid Update

During last week's meeting with DOH, LeadingAge NY and other provider associations continued identifying issues to address as the state transitions nursing home residents into Medicaid managed care. Medicaid-only residents, statewide, (i.e., those eligible for Medicaid, but NOT ELIGIBLE for Medicare) are scheduled to transition to managed care in October of this year. DOH is forming a work group to address transition issues. Along with participating on this work group, LeadingAge NY is forming a work group of nursing home and MLTC members to work in tandem with the state's group. 

DOH also updated LeadingAge NY on the next steps regarding the proposed Universal Settlement. They are recalculating individual provider impact estimates and hoping to circulate draft language shortly.  

Later this week, LeadingAge NY will meet with DOH and OMIG to review the MDS audit findings from the 80-some audits that OMIG has performed so far. At that meeting, we expect to learn the timing of final July 1, 2012 rates as well as the timeline for audits and payments related to subsequent case mix updates. We will provide members information on these issues after the meeting. 

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