Initial 2015 LTHHCP Rates Available

DOH posted a Dear Administrator Letter (DAL) on the Health Commerce System (HCS) detailing the Long Term Home Health Care Program (LTHHCP) initial 2015 Medicaid rates. Please log into your HCS account to see your initial 2015 Medicaid rate computation sheet for the period beginning Jan. 1, 2015. The DAL states that the initial rates are all-inclusive and based on the lower of 2013 allowable costs (held to regional ceilings) projected to the 2015 rate period as reported in your 2013 cost report, and it also outlines the appeal process.

Some of the additional LTHHCP issues outlined include:

a zero percent trend factor as per the 2014-15 budget;
statewide average cap on administrative and general costs of 25.75 percent is based upon the 2013 costs;
a worker recruitment and retention adjustment of an increase of three percent for those providers who submitted their attestations;
an additional 4.7 percent rate add-on for the recruitment, training and retention adjustment proportionally adjusted based on total annual hours of service to Medicaid patients;
NYC wage parity 2015 fee-for-service rates for NYC LTHHCP continues to include a minimum rate for both home health aides and personal care aides of $20.95 per hour;
the hotline appeals process will be in effect until Feb. 2, 2015. According to the DAL, providers may phone the Bureau of the Long Term Care Reimbursement (BLTCR) with inquiries as to the accuracy of the rates. However, to effect a change in your rate through the accelerated administrative process, you must submit your written appeal to the Bureau, postmarked no later than Feb. 2, 2015;
revisions to the 2013 annual cost report, any Hotline appeal item that alters the 2013 cost data requires the 2013 annual report to be filed electronically through HCS by February 2, 2015; and
an appeal to the initial 2015 rate computation must be filed with the BLTCR, and postmarked no later than April 15, 2015 in an email submitted to doh.sm.BLTCR-LTHHCP. The DAL outlines the information that has to be submitted with the appeal.

Any questions related to the methodolgy used in the calculation of the 2015 Mediciad rates or the accuracy of the rates should be directed to Russ Smith at 518-473-4421.

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