Nursing Home Universal Settlement Discussion Proceeds

LeadingAge New York and other associations representing nursing homes throughout the state met yesterday with officials from the Governor’s Office and the Department of Health (DOH) to discuss DOH’s proposed universal settlement of Medicaid rate appeals and litigation. After a series of inter-agency discussions, the state is proposing to move forward with the process.

Under the proposed settlement, a total of $475 million would be provided to nursing homes statewide over five years (an estimated $75 million in 2013 and $100 million annually in 2014-2017) to mitigate losses and accelerate gains resulting from implementation of statewide pricing. In exchange, facilities would be expected to execute legally binding settlement agreements with the state relinquishing their rights to any financial relief from most non-capital rate appeals and lawsuits relating primarily to pre-statewide pricing rates (i.e., prior to 2012). The state’s goal remains to get all nursing homes to participate in the settlement.

Based on the state’s desire to begin making settlement payments in the current state fiscal year (which ends March 31, 2014), the associations are being asked to provide input on the terms of the agreement and a distribution methodology for the funding by next week. Following consideration of the association input, DOH plans to conduct a webinar in early December to brief all nursing homes in the state on the settlement agreement and the associated Medicaid rate impacts.  Facilities would then be asked to execute the agreement within a relatively short timeframe following the webinar. Depending on whether there is sufficient interest among facilities, the state would pursue federal approvals and plan to begin making payments prior to March 31, 2014.

LeadingAge NY encourages member facilities to begin to review their inventories of unprocessed rate appeals and any outstanding litigation, in anticipation of providing a response to the settlement proposal as early as five to six weeks from now. As further information is gleaned, we will share it with you. The LeadingAge NY Legal Services Committee will be meeting later this week to discuss and provide feedback on the potential settlement.       

Contact: Dan Heim, dheim@leadingageny.org, 518-867-8866