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Reimbursement Issues

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

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
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