Outstanding Medicaid Payments Headed for Nursing Homes, ADHC, and Hospice
(Oct. 1, 2024) The State share of additional funding enacted in this year’s State Budget will be paid in Medicaid payment cycle 2458, scheduled to be released on Oct. 16th. For nursing homes, adult day health care (ADHC) programs, and hospice providers, this is a total of $142.5 million, which will be distributed as a lump sum payment calculated based on 2022 Medicaid days. The remaining $142.5 million will be distributed when the Centers for Medicare and Medicaid Services (CMS) approves the associated State Plan Amendments (SPAs) which were just recently submitted.
As described in the Dear Administrator Letter (DAL), this “one time investment” payment is being made as a lump sum payment outside of the Medicaid rate. The State-share payment represents approximately $6.78 per 2022 billed Medicaid day for nursing homes as well as ADHC and hospice programs. Once CMS approves the State’s Medicaid SPA, it is expected that providers will receive the remaining $6.78 per Medicaid day representing the federal share.
Please note that the 10 percent cut to the nursing home Medicaid capital component which was also enacted this year is not reflected in this payment adjustment. Although approved by CMS, the rate adjustments associated with that cut are still in Executive review and will be implemented at a future date. For nursing homes that participate in the CINERGY Collaborative, the State share of 2024-25 CINERGY payments will also be included in payment cycle 2458.
The payment DAL is available here. Please note that any outstanding Medicaid liabilities will be offset from the payment.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841