powered by LeadingAge New York

ALP Minimum Wage Reconciliation Hits

The Department of Health (DOH) has calculated minimum wage reconciliation amounts for Assisted Living Programs (ALPs) for rate years 2017 through 2021. The original process had been delayed and has included a number of revisions and corrections, but adjustments are now set to be reflected in payments made starting with Medicaid cycle 2333. A Dear Administrator Letter (DAL) dated May 23rd outlines the process that the Department will use for making recoupments and payments related to reconciliation, which varies based on whether a provider has an existing liability. The DAL was accompanied by an Excel workbook that outlined the impact on each program and the adjustment amount scheduled for cycles 2333 and 2334. Any remaining liability will be recovered through a 15 percent recoupment that will be applied to each Medicaid payment until satisfied. The DAL, Excel sheet, as well as the detailed reconciliation spreadsheet can be found here.

While providers should review the DAL, highlights include:

  1. DOH moving forward with reconciling minimum wage for 2017 through 2021.
  2. DOH is NOT making the 1.5 percent across-the-board cut for the last two years of ALP payments that have not been implemented for ALPs at this time.
  3. Impact begins with Medicaid billing cycle 2333 (May 25th check release date).
  4. DOH has issued another set of updated numbers reflecting actual billing days (indicating that previous figures included some estimates).
  5. Recoupments for those with negative adjustments start in Medicaid billing cycle 2333.
  6. Programs with positive adjustments but with prior liabilities should consult the DAL.
  7. Important to review numbers – if they do not add up, contact DOH (ALP-Rates@health.ny.gov) and please let us know.
  8. Recoupment for outstanding liabilities is at 15 percent of the Medicaid check. Providers can contact DOH to request a lower recoupment rate if 15 percent is a hardship by sending an email with the name of your facility and MMIS# in the subject line to bimamail@health.ny.gov.

Contact: Darius Kirstein, dkirstein@leadingageny.org, or Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8383