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2016 CHHA Hotline Rates for Pediatric Patients and 2015 Cost Report Software Posted

On June 20th the Department of Health (DOH), Bureau of Managed Long Term Care, posted the 2016 "Hotline" rate calculation sheets on the Health Commerce System (HCS) website for each non-hospital-based Certified Home Health Agency (CHHA) that filed a properly certified, full-year 2014 cost report. These rates will be used for patients who are exempt from the Episodic Payment System, such as patients under 18 years of age, and for patients served by a pilot program which provides services to a special needs population of medically complex and fragile children, adolescents and young disabled adults.

To find the rate calculations, go to the "Rate Publication Selection List" drop-down under the date of June 20, 2016. DOH also posted a corresponding Dear Administrator Letter (DAL). Outlined in the DAL include, effective Jan. 1, 2016, a zero percent trend factor; a 4.7 percent uniform percentage add-on to provide funding for purposes of improving recruitment, training and retention (RT&R) of home health aides or other personnel with direct patient care responsibility; and a three percent add-on for those CHHAs which submitted to DOH a signed certification statement attesting that the funds received will be utilized solely for the purpose of recruiting and retaining non-supervisory home care service workers or any worker with direct patient care responsibility.

An appeal by a provider whose rates have been changed by the Hotline process must be filed no later than 30 days after the DAL was posted on HCS.  

DOH has also posted the 2015 non-hospital CHHA cost report software on HCS. This cost report, operator's certificate and accountant certification are due by Sept. 15, 2016. DOH posted a corresponding DAL as well. The DAL highlights a change in the 2015 cost report. On page one under General Information, providers must enter the Begin Date and End Date of the period covered by the report; DOH provides examples.

If you have any questions related to the methodology utilized in the 2016 Medicaid rates for pediatric patients or the 2015 cost report and certification access, please contact Charles Tobey or Tim Casey at 518-473-4421. If you have questions regarding HCS, please contact the HELPLINE at 1-866-529-1890.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871