Nursing Homes to Receive Outstanding 1 Percent Rate Increase
(July 16, 2024) Sixteen months after it was made law, nursing homes are set to receive an outstanding 1 percent Medicaid rate increase. In November 2023, the Department of Health (DOH) incorporated a 6.5 percent increase into Medicaid rates (retroactive to April 1, 2023) while awaiting approval from the Centers for Medicare and Medicaid Services (CMS) for the full 7.5 percent increase that was enacted as part of the 2023-24 State Budget. It is that missing 1 percent, retroactive to April 1, 2023, that providers will see reflected in Medicaid payment cycle 2448, which has a check release date of Aug. 7th. It applies to both nursing home and Adult Day Health Care (ADHC) Medicaid rates.
Members will recall that the 6.5 percent increase to the rate is reflected on line 13 (Misc. per diem adjustments) of the Medicaid rate sheet. This is the same line where the additional 1 percent will appear. DOH will post an updated backup spreadsheet detailing all of the individual adjustment amounts that are reflected in the line 13 total on the DOH public reimbursement page as well as on the Health Commerce System (HCS). Members can validate the approximate amount by subtracting the capital component of their rate and multiplying the remaining amount by 1 percent.
Please note that this comes on the heels of January 2024 rates that were issued on June 20th and will be paid in Medicaid cycle 2445 being released July 17th. This earlier transaction updated the nursing home capital rate and made minor tweaks to existing adjustments that were driven by changes to the operating rate since January 2023.
ADHC program capital rates were not updated when nursing home capital rates were, but programs will see the impact of the update to 2024 capital rates in cycle 2448. The 2024 capital rates will be based on 2022 reported costs and may represent the first capital update in several years, since DOH had continued using 2019 data for the ADHC capital due to disruption to ADHC operations during COVID. The capital rate update may represent an increase or a decrease based on program-specific dynamics.
The nursing home Dear Administrator Letter (DAL) is here; the ADHC DAL is here.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841