DOH Posts Nursing Home Rates
On July 7th, the Department of Health (DOH) notified nursing home providers of the posting of initial updated January 2022 Medicaid Operating Rates on the Healthcare Financial Data Gateway of the Health Commerce System (HCS). Members will recall that due to long delays in completing the 2022 capital calculations, DOH opted to issue January 2022 rates in two phases.
This first phase includes updates to the operating component for case mix and minimum wage and “rebases” the 1.5 percent add-on in place since November 2018 by calculating it from the 2022 operating rate (as opposed to continuing with a frozen, 2018-based figure). The add-on has always been included on line 13 (“Misc. per diem adjustments”) along with other adjustments such as minimum wage, 2 percent quality penalty for those subject to the penalty, and 5 percent capital cut. Eventually, DOH will post a file listing each adjustment separately, but at this point, the most recent list is from 2021. The second phase of the rates will be the issuance of the 2022 capital component, which is currently under executive review. DOH is working through the details of the Medicaid 1 percent increase, with no estimate on when it will be incorporated into the rates.
The payment adjustment for Phase 1, retroactive to Jan. 1, 2022, will be reflected in Medicaid payment cycle 2343, scheduled for release on Aug. 3, 2022. The Dear Administrator Letter (DAL) accompanying the rate update is available here. Please let us know if you encounter problems accessing the rates or identify any discrepancies.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841