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Reimbursement Issues

Reimbursement Issues

DOH Issues Guidance on FI Administrative Reimbursement

MLTC Policy 21.02 outlines Medicaid FFS reimbursement for CDPAS FI administrative costs, reaffirms managed care plans may use the same rate structure at their option.

March 15, 2021

Reimbursement Issues

MLTC Minimum Wage Reconciliation Posted

The SFY 2019-20 Minimum Wage Reconciliation Cost Report is due on Jan. 4th; MLTC Quality Pool payment scheduled.

December 1, 2020

Reimbursement Issues

DOH Reviews Partially Capitated MLTC Rates, Issues Rate Sheets

September MLTC Finance Meeting features a walkthrough of 2020-21 rates and an outline of the timing of expected rate updates.

September 21, 2020

Reimbursement Issues

CMS Issues Medicare Advantage Advance Notice

First of two notices comes early and covers risk adjustment changes for 2022 rates.

September 15, 2020

Reimbursement Issues

MLTC Rate Development Update

Deloitte presentation includes information on trend development, as well as administrative and care management component amounts for 2020-21 Partially Capitated MLTC rates.

July 27, 2020

Reimbursement Issues

June MLTC Finance Meeting Highlights

DOH outlines funding pool distribution calculations and provides target dates for rate updates.

June 9, 2020

Reimbursement Issues

Deloitte Reviews MLTC Base Data

Base cost data indicates overall increases upstate, slight decrease in New York City area in 2018 relative to 2017.

April 27, 2020

Reimbursement Issues

MLTC Plans Subject to Additional Cuts

MAP and partially capitated plans face January 2020 cuts in addition to the 1 percent across-the-board cut.

February 7, 2020

Reimbursement Issues

Partial Capitation MLTC Rates Set for Payment

Payment on April 2019 rates for Partially Capitated MLTC plans is scheduled to begin Nov. 27th.

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
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