State Deems Settlement Participation "Universal"

LeadingAge NY learned from the Department of Health (DOH) and Governor’s Office that the State has agreed to move forward on the universal settlement of nursing home rate appeals and litigation. In other words, the State has determined that the response from facilities was sufficiently “universal” to proceed to the next steps. As previously reported by LeadingAge NY, approximately 97 percent of all current nursing home operators voted in favor of the proposed $850 million universal settlement.

State officials have also reported that they have scheduled a meeting with the Centers for Medicare and Medicaid Services (CMS) on universal settlement. Because the federal government would contribute 50 percent of the total settlement funding, CMS will need to approve a Medicaid State Plan Amendment authorizing the plan. The State is also drafting a settlement agreement that would need to be executed by each participating facility and the State of New York, which LeadingAge NY, other associations and counsels will be reviewing.

While the State’s determination of “universality” is an important first step in the process, much work remains to be completed before the universal settlement can become a reality. For this reason, it is currently impossible to predict whether/when the first payment will be made. 

LeadingAge NY and other associations will be facilitating the process by which participating facilities compile and submit information on any rate appeals and lawsuits they have outstanding which they believe would be excluded from the universal settlement. To expedite this process, we urge all nursing home members to continue to inventory their outstanding appeals and litigation for those claims that may be excluded under the Universal Settlement Term Sheet approved by the State. Please be on the lookout for an e-mail this week providing guidance on submitting this information. With the State budget process driving the timeline for facility submission, and DOH review of appeals and litigation excluded from the settlement, the requested turnaround time will be tight.    

Contact: Dan Heim, dheim@leadingageny.org, 518-867-8383