DOH Processes NHQI Payment Adjustments
(April 22, 2025) The Department of Health (DOH) has processed Medicaid payment adjustments related to the 2023 Nursing Home Quality Initiative (NHQI). Providers should see associated payment adjustments in Medicaid cycle 2487, scheduled to be released on May 7th. The adjustment amounts and backup calculations have not yet been posted, but providers can calculate a rough estimate using their annual Medicaid revenue. Those in the best quintile should see a positive adjustment of about 1.2 percent of Medicaid revenue, those in the second quintile should receive about 0.8 percent, while those in the third quintile would see a modest positive amount. Facilities in the fourth and fifth quintile will face a negative adjustment totaling approximately 0.8 percent of annual Medicaid revenue. As usual, DOH will reduce payments by any outstanding Medicaid liabilities. The Dear Administrator Letter is available here; the quintile assignments are posted on the DOH website here.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841