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2016 Assessment Reconciliation Complete

The Department of Health (DOH) has processed the reconciliation of the 2016 nursing home Cash Receipts Assessment payments, and the resulting adjustment will be included in Medicaid Payment Cycle 2106 (check dated Jan. 1, 2018, to be released on Jan. 17th). The reconciliation compares the per-day assessment reimbursement amount that homes received from fee-for-service Medicaid in calendar year 2016 to the recalculated assessment reimbursement amount based on actual assessment payments made in 2016. The adjustment may be positive or negative based on each home’s individual circumstances.

DOH has prepared a spreadsheet (similar to the benchmark rate list) showing key figures to help providers understand and verify their home’s calculation. We will let you know as soon as that listing is posted. Note that the reconciliation impacts assessment reimbursement made through fee-for-service Medicaid only. Assessment reimbursement amounts reflected in the benchmark rate paid by managed care plans are based on a two-year lag (i.e., 2017 rates contained 2015 reconciled assessment reimbursement amounts) and are updated annually, but not reconciled.

The Jan. 1, 2018 nursing home Medicaid fee-for-service and benchmark rates are being finalized and should be posted shortly.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841