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Reimbursement Issues

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 10th, Minimum Wage Reconciliation Cost Reports on April 5th.

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

Reimbursement Issues

MLTC Risk Adjustment Workgroup Meets

DOH and Deloitte are seeking stakeholder input on additional variables to include in the MLTC risk model.

November 12, 2018

Reimbursement Issues

DOH Discusses Minimum Wage Guidance, Reconciliation

Webinar presentation aimed at both plans and home care providers reviewed previously issued guidance and outlined the reconciliation process.

October 1, 2018

Reimbursement Issues

MLTC Data Request Due May 18th

All plans, including integrated plans, are requested to submit information on nursing home members to facilitate 2017-18 Medicaid rate revisions.

May 11, 2018

Reimbursement Issues

MLTC Rate Adjustments Coming in Mid-May

DOH has processed revisions to April and July 2017 rates.

May 4, 2018

Reimbursement Issues

DOH Offers Recorded Medicaid Budget Briefing

State Medicaid Director Jason Helgerson commented during the presentation that "many of us have been concerned about the potential growth in long term care in Medicaid for a long time with the aging of the baby boom generation."

February 9, 2018
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