Latest Developments on CHHA EPS Rebasing Cuts

The Governor has vetoed (#271) legislation (S.5878/A.8171) entitled, "AN ACT to amend the public health law, in relation to rebasing of the episodic reimbursement methodology for certified home health agencies" which sought to limit Medicaid cuts as a result of rebasing of the CHHA Episodic Payment System (EPS) to levels passed in this year’s state budget. 

The Governor's veto states, “this bill would set a dangerous precedent of setting Medicaid provider reimbursement levels based on estimates, rather than levels that reflect actual data. Specifically, it would prevent the Department of Health from updating rates to fully reflect updated reimbursement and population acuity trends. It would also override the rebasing process to generate artificially higher rates of Medicaid reimbursement to providers.” The veto then directs this issue to be addressed in the context of budget negotiations.

LeadingAge New York identified during negotiations on the current state budget and joined with other home care associations to propose legislation limiting the rebasing to the $ 30 million cap as approved in the budget. We urged Certified Home Health Agencies (CHHAs) members to advocate for this legislation by sending an email to lawmakers requesting that they limit any CHHA rate cuts to cap.

As reported, the State is required to rebase the rates not less frequently than every three years. The Department of Health (DOH) planned to replace the 12 percent cut to current rates by a full rebasing that would not only reduce the base price, but would also re-weigh each of the 108 payment groups and alter the grouper, effective Oct. 1, 2015. They received approval from the Division of the Budget for the full rebasing and issued a Dear Administrator Letter (DAL) in August 2015 with a complete description of the changes, including a percentage in excess of 12 percent, as high as 28 or 36 percent. Again, this is well beyond the cap found in the state budget.   

LeadingAge NY has met with the Governor’s Office staff to express our concerns and proposed solutions to this excessive cut. We will evaluate our next steps and keep members posted on any new developments.

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