Reimbursement Issues

Reimbursement Issues Partial Capitation MLTC Rates Set for Payment: Payment on April 2019 rates for Partially Capitated MLTC plans is scheduled to begin Nov. 27^th.
November 4, 2019

Reimbursement Issues DOH Updates Benchmark Rates, Distributes ATI Funding: Plans notified of nursing home benchmark rate updates, funding distribution requirements.
October 22, 2019

Reimbursement Issues DOH Suspends CDPAP Reimbursement Changes: Guidance related to changes to the FI reimbursement methodology is on hold until further notice.
October 21, 2019

Reimbursement Issues DOH Clarifies MLTC Minimum Wage Report Instructions: Plans should ensure that the data on their Minimum Wage Reconciliation Cost Report for the first quarter of 2018 is accurate.
October 7, 2019

Reimbursement Issues New Home Care Cost Report in the Works: Comprehensive cost report is scheduled to start collecting LHCSA and FI data next year.
September 10, 2019

Reimbursement Issues DOH Work Group Discusses Revisions to Value-Based Payment Roadmap: Proposed revisions align MLTC provisions of the Roadmap with previously issued policy directives and also impact social determinants of health interventions.
May 14, 2019

Reimbursement Issues CMS Finalizes Medicare Advantage Rates: Plans receive guidance on providing supplemental benefits, see a 2.5 percent average rate increase.
April 2, 2019

Reimbursement Issues Upcoming MLTC Reporting Dates: Cost Reports are due on April 10^th, Minimum Wage Reconciliation Cost Reports on April 5^th.
April 1, 2019

Reimbursement Issues MLTC Risk Model Workgroup Meets: Deloitte staff outline the modeling they have done as they seek to develop a more predictive risk adjustment model.
March 25, 2019

Reimbursement Issues Medicare Advantage Draft Call Letter Modifies Rate Methodologies and Outlines New Supplemental Benefits: The Advance Notice and Draft Call Letter cover all Medicare Advantage plans, Programs of All-Inclusive Care for the Elderly, and Medicare-Medicaid plans, as well as Part D plans and employer-union plans. They contain modifications to the Medicare Advantage quality rating system, information to assist plans as they prepare their bids for the new contract year, and information about new Supplemental Benefits for Chronically Ill beneficiaries.
February 19, 2019