Information on Rate Update Expected

While DOH has experienced some delay in completing rate recalculations based on the findings of the first round of OMIG MDS audits, they anticipate to have sufficient information to announce their direction this week.  We will be meeting with them on Wednesday, June 5, to discuss this and other nursing home Medicaid issues.   

Some 300 homes that saw an increase in case mix greater than five percent from January 2011 to January 2012 are being paid July 2012 rates that reflect a CMI adjustment constrained to a five percent change.  DOH will use the rate recalculation data to decide whether or not to release final July 2012 rates without the CMI constraint.      

The state remains concerned about the increase in the count of Medicaid residents in rehabilitation RUG categories that has been observed statewide but has indicated that the decision regarding final July 2012 rates will be based primarily or exclusively on OMIG audit results.  We will provide an update to members after the meeting.

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