DOH Posts July Nursing Home Medicaid Rates
On Sept. 29th, the Department of Health (DOH) notified nursing homes that July 2023 Medicaid Rate Sheets have been posted on the Financial Data Gateway section of the Health Commerce System (HCS). The rates are updated for case mix, which is calculated using all Medicaid Minimum Data Set (MDS) assessments with Assessment Reference Dates (ARDs) spanning Oct. 1, 2022 through March 31, 2023. Because specialty rates are not subject to case mix adjustment, there is no July rate update for specialty facilities/units.
Payment adjustments retroactive to July 1, 2023 will be in Medicaid payment cycle 2406, which has a check release date of Oct. 18th. The associated Dear Administrator Letter (DAL) is available here. Note that the 7.5 percent rate increase enacted in the 2023-24 State Budget is not yet reflected. Once federal approval is received, we expect that DOH will update rates to incorporate the increase retroactive to April 1, 2023.
These July rates are scheduled to be the second-to-last rates calculated using a case mix index that relies on Resource Utilization Group (RUG) categories. After DOH calculates January 2024 rates, case mix will be frozen until the State implements a new case mix adjustment system that will resemble the Patient-Driven Payment Model (PDPM) methodology used to calculate Medicare Part A rates. DOH formally notified providers of the State’s plan in a DAL available here.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841