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Reimbursement Issues

Reimbursement Issues

DOH Outlines Plans for Home Care Minimum Wage Increase and Premium Adjustments at Managed Care Finance Meeting

The meeting covered the expected timing and elements of premium revisions, including revisions to SFY 2022-23 rates based on the home care worker minimum wage increase, independent assessor implementation, and updated risk scores.

June 14, 2022

Reimbursement Issues

DOH Planning Risk Score Update to MLTC Rates

Plans encouraged to ensure that all members have a completed assessment for the 12-month period ending Sept. 30, 2022 as DOH prepares a mid-rate-year risk score update.

June 7, 2022

Reimbursement Issues

Deloitte Outlines 2022-23 Rate Development Process for MAP and Partially Capitated MLTC Plans

Adjustments and underpinning assumptions raise rate accuracy concerns at managed care finance meeting.

March 1, 2022

Reimbursement Issues

Managed Care Minimum Wage Reconciliation Report Deadline Extended

Reports are now due by close of business on Dec. 13th.

December 7, 2021

Reimbursement Issues

Medicaid Managed Care Minimum Wage Reconciliation Survey Activated

The Supplemental Minimum Wage Reconciliation Cost Report for SFY 2020-21 is due by close of business on Dec. 6th.

November 9, 2021

Reimbursement Issues

Deloitte Presents on MLTC Trend Development

April Plan Finance Meeting focuses on next step in development of 2021 rates.

May 4, 2021

Reimbursement Issues

DOH Shares Draft Enrollment Cap Methodology

Presentation provides preview of proposed approach for calculating 2021-22 enrollment caps for partially capitated MLTC plans; webinar being scheduled.

April 27, 2021

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
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