DOH Posts Nursing Home Rates

Nursing home providers may now download their 1/1/14 Medicaid rate sheets that reflect case mix adjustments based on their July 2013 census roster.  Please note that homes whose July 2013 Case Mix Index (CMI) changed by more than five percent from the January 2013 roster-based CMI will have the change constrained to five percent pending MDS audit. 

The rate schedule has been sent to e-MedNY for payment and homes should be receiving the updated rate as of now.  Adjustments retroactive to 1/1/14 are expected to be in Medicaid payment cycle #1924 with a check release date of 7/23.  The DOH notice which includes instructions on how to access the rate sheets on the Health Commerce System (HCS) is copied below.

DOH has also completed the 2011 cash receipts assessment reconciliation.  Those adjustments will be reflected in Medicaid payment cycle #1925 which has a check release date of 7/30.

Contact:  Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841

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TO ALL NURSING HOME ADMINISTRATORS:

This is to inform you that the Medicaid rates for your facility effective January 1, 2014 (case mix) and supporting documentation along with the associated Dear Administrator letters are now available on the Health Commerce System (HCS). To access, please follow these instructions:

Go to Website - https://commerce.health.state.ny.us/

Security Screen - enter your “HCS” id and password

Health Commerce System Welcome Page - select "NH Rate Sheets 4/2009-Forward" under the heading "My Applications"

Nursing Home Rates - 4/1/2009 and Forward screen - select "NH January 2014 Case Mix Update July 2013" from the drop-down list under "Nursing Home Rates Selection List"

Identify your facility in the drop-down list under "Nursing Home Selection List" and then select "SHOW REPORTS"