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DOH Posts Nursing Home Rate Sheets Incorporating 6.5 Percent Rate Increase

At the end of last week, the Department of Health (DOH) posted nursing home rate sheets reflecting the 6.5 percent increase to Medicaid rates that is retroactive to April 1, 2023. Members should be able to access April 2023 as well as revised July 2023 rate sheets that reflect the 6.5 percent increase on the Health Commerce System (HCS). Payment of the new rates retroactive to April 1, 2023 should be in Medicaid payment cycle 2408, which is scheduled to be released on Nov. 2nd. Although updated Adult Day Health Care (ADHC) rate sheets have not yet been posted, the increase to ADHC rates, also retroactive to April 1, 2023, should be in payment cycle 2408 as well. Please note that nursing home providers should see payment adjustments reflecting a case mix update retroactive to July 1, 2023 in Medicaid cycle 2406 that is scheduled for release this week. DOH posted the Assisted Living Program (ALP) rate increase amounts on its website previously.

Nursing home members will note that the rate adjustment amounts related to the 6.5 percent increase on their July rate sheets may be the same as on the April rate sheets. We believe that the Department’s intention is to recalculate the increase each time that the operating rate changes and are seeking clarification on this dynamic. We will share more information with members as it becomes available. In the meantime, we encourage members to review their rates for accuracy and to let us know if they observe any discrepancies. More information on the rate increase is available here.

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