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DOH Posts 2022 Capital Preview Rates

On March 29, 2022, the Department of Health (DOH) issued a Dear Administrator Letter (DAL) indicating that the 2022 Nursing Home and Adult Day Health Care (ADHC) capital preview rates were available for review on the Healthcare Financial Data Gateway section of the Health Commerce System (HCS). Although this process that customarily starts in early fall was delayed for several reasons, providers have 45 days to review their capital rate calculations and indicate whether or not the calculation requires revision by submitting a signed attestation form (available here) to DOH by May 13th. Homes seeking a revision are required to submit an attestation correction request form (on the HCS and available for download here) indicating the reason for the revision request, and, if applicable, provide an explanation with supporting documentation.

DOH indicates that the reasons for revision requests fall into three categories:

Cost Report Error. If the amount on the rate sheet is incorrect due to an error in the filed 2020 cost report, then the facility must submit a revised 2020 cost report as required by regulations. This is the one change that DOH is implementing starting this year. To help providers understand the process DOH follows in setting capital rates, DOH has developed a crosswalk that maps each line of the capital rate sheet to its data source (on the HCS and available for download here).

New or Refinanced Mortgage in 2021 and 2022. DOH’s mortgage database (posted on HCS and also available here) is compared to Schedule 17 on the cost report. Providers are asked to verify the database for accuracy, and those who have a new mortgage or who have refinanced an existing mortgage are asked to provide supporting documentation to the Department, including the signed mortgage terms, sources and use of funds, and the corresponding amortization schedule.

Additional Information. Capital reimbursement is allowed for changes in ownership, interim and final Approved Project Costs (APCs), organization/start-up costs, and working capital interest. Please provide supporting documentation to the Department if you would like to request reimbursement for these items.

Given the new requirement to refile the cost report if needed to correct reporting errors impacting capital rate calculations, we urge members to review their capital rates without delay. Forms should be submitted to DOH at nfrates@health.ny.gov.

In a related matter, we remind members who had appeals processed recently that DOH has extended the deadline for requesting hearing appeals for those transactions if necessary until April 15th. The DAL outlining the process is here, although please note that the extended appeal-by date of April 15th is not reflected in that document. The lump sum payments from appeals related to rate years 2009 through 2020 were in Medicaid cycle 2324 (released March 23rd), while appeals impacting 2021 will be in rate cycle 2325 (released March 30th).

Please contact us if you have questions or concerns with either process.

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