Nursing Home Supplemental Payments En Route
Nursing home providers should see the nursing home 2 percent supplemental payments for State Fiscal Year (SFY) 2023-24 in Medicaid payment cycle 2427 (check date Feb. 26th, released March 13th). The supplemental payments represent the reinvestment of the 0.8 percent un-reimbursed portion of the cash receipts assessment that is paid by nursing homes back into nursing home care. The lump sum amount should total approximately 2 percent of a facility’s annual Medicaid revenue, inclusive of specialty units. The statewide distribution totals $140 million.
Reconciliation. Note that for purposes of distributing the supplemental payments, the Department of Health (DOH) calculates revenue by multiplying the Medicaid rate by Medicaid days. The Department uses the most currently available Medicaid days in the calculation and reconciles to actual Medicaid days in the following year. The revenue calculation used for this 2023-24 distribution uses 2022 Medicaid days and will be reconciled to actual 2023 Medicaid days next year. That reconciliation will be incorporated as an adjustment to next year’s supplemental payments.
The same reconciliation applies to this year’s payments. Because last year’s distributions were calculated using 2021 Medicaid days, they have been recalculated using actual 2022 days, with the resulting difference added to or subtracted from this year’s payment. Those whose Medicaid days increased from 2021 to 2022 will see a positive reconciliation; those with a year-over-year decline in Medicaid days will see a negative adjustment.
Backup Figures. Once available, LeadingAge NY expects that DOH will post the backup calculations on the DOH site here (click on Nursing Home Quality Pool (NHQP) and 2% Supplemental Payment). Once posted, the file should include a listing of the days used in this year’s calculations as well as the adjustments applied to reconcile the prior year’s payments. The associated Dear Administrator Letter (DAL) is available here. Note that NHQP payment adjustments are no longer made at the same time as the 2 percent supplemental payments. The 2022 NHQP adjustments are in executive review and will be made at a later date. We will let members know when we have more information on the timing of the NHQP payments as well as when the backup figures for the supplemental payments are posted.
Outstanding Medicaid Liabilities. As detailed in the DAL, facilities with outstanding Medicaid liabilities will have these liabilities subtracted from their supplemental payment. Those subject to liability offsets will receive their remaining supplemental payment in a check by mail, rather than through direct funds transfer.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841