DOH Processes Second Round of Historic Appeals
(Dec. 16, 2025) Last week, the Department of Health (DOH) notified impacted nursing homes that payments for the second batch of historic Medicaid rate appeals covering 2009 through 2021 will be paid in cycle 2520, scheduled for Dec. 24th release. The associated Dear Administrator Letter (DAL) is available here.
DOH notes that not all appeals that were verified through the “rate appeal attestation exercise” conducted in the fall of 2023 (during which homes reviewed outstanding appeals for accuracy and appropriateness) are included in this posting. Providers that verified their open appeals information and submitted necessary documentation during the “appeals exercise” and are not included in this lump sum payment package require further review and possibly additional documentation. The first round of payments related to this initiative was released on Jan. 15, 2025. While an additional round is expected, members should keep in mind that state law caps the total appeal payments that DOH may make in a fiscal year. We will continue to push for the processing and payment of outstanding member appeals and invite members to let us know about historic "appeal exercise" claims that remain outstanding.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841