Nursing Home Universal Settlement Exclusions

Earlier this year DOH requested that homes submit a list to the state, through their associations, of items that should be excluded from the Universal Settlement of Litigation and Appeals.  Excludable items were detailed on the Universal Settlement term sheet. DOH has now developed a process for providers to review DOH determinations regarding items homes included on their exclusion lists. The state will post exclusion determination reports on the Health Commerce System (HCS) which will indicate if there are any exclusions that a home reported that DOH believes is inappropriate.  Homes with rejected exclusions will be provided a short time frame to submit additional documentation to substantiate the exclusion claim.  

An attempt last week to post excluded appeal listings was thwarted by technical difficulties resulting in providers not being able to access their list even though they had submitted exclusions.  DOH removed the posting and will attempt to repost the information as soon as the problem is resolved.  Once reposted, DOH will notify providers by e-mail and LeadingAge NY will echo the notification to members.  A similar process will be followed shortly regarding excluded litigation and OMIG audit discontinuation requests.  If you no longer have access to the HCS because your facility is in transition, contact Matt Leonardo, Matthew.Leonardo@health.ny.gov, to request a copy of the report once the posting announcement is made.

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