Universal Settlement Update
An agreement has been reached between the State of New York and legal counsels representing nursing homes on the terms of an $850 million universal settlement of most Medicaid rate appeals and reimbursement litigation. A formal term sheet has been developed and circulated. Based on DOH formulaic calculations and consensus among legal counsels in valuing pending litigation, each non-specialty nursing home in the State would receive five annual payments to settle most outstanding Medicaid rate appeals and Medicaid reimbursement-related litigation. Members should have received their facility-specific benefit estimates from LeadingAge NY last week.
To esure inclusion of required provisions in the State budget and to increase the possibility of timely CMS approval, the State is providing a very tight timeframe for nursing homes to indicate their interest in participating in the settlement. DOH is seeking to have responses from all facilities by Fri., Jan. 9, 2015, and is requesting that all homes complete a brief, on-line survey available here.
LeadingAge NY, along with other associations representing nursing homes, held a webinar on Dec. 29 to provide an overview of the proposal and answer questions. The webinar was recorded and is available here. The slides from the presentation are here. We will be compiling and distributing a list of Frequently Asked Question (FAQs) in the next few days, as well.
A memo summarizing the Universal Settlement is available here. Additional resources available to assist each facility in making a decision about Universal Settlement participation (identical to those distributed to members along with their benefit estimates) include:
- the Universal Settlement Term Sheet approved by the State;
- the Associations’ Summary of the Term Sheet provisions;
- a DOH-generated master lists of pending rate appeals; and
- a DOH-generated master lists of pending litigation.
Homes that have not received their benefit estimates are encouraged to contact us. Please note that outstanding Medicaid liabilities owed to the State will be offset from the settlement distributions, and that your facility's allocation may be subject to the claims of former owners.
We encourage members to review the available materials closely, consult with their legal counsel and their audit firms as needed and contact us with questions.
Contacts: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8383, ext. 104 or Dan Heim, dheim@leadingageny.org, 518-867-8383, ext. 128