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LeadingAge NY Objects to Timing of Medicaid Bed Hold Changes

LeadingAge NY has asked the Department of Health (DOH) in writing to delay the effective date of previously adopted changes to Medicaid reserved bed days payment and policy. Our request comes in the wake of a July 3, 2019 DOH Dear Administrator Letter (DAL) indicating that all Medicaid claims for hospitalization bed holds for residents age 21+ who are not on hospice would be denied beginning May 29, 2019.

Our letter points out that the July 3rd DAL was issued five weeks after the May 29th adoption of the regulations and failed to offer guidance to nursing homes on modifying or communicating their policies to comply with the new regulations. We expressed concern that due to the lack of timely guidance, nursing homes will have extended bed reservations to Medicaid beneficiaries for which they will not be reimbursed and have other questions that are as of yet unanswered. Our letter concluded with a request that DOH suspend implementation of the new regulations and maintain reimbursement of hospitalization reserved bed days, pending issuance of clear guidance to nursing homes, hospitals, and managed care plans.

DOH has indicated that they plan to issue further guidance on the bed hold changes in the near future. We will keep members posted with the latest information on this subject, including the status of our request to DOH.

Contact: Dan Heim, dheim@leadingageny.org, 518-867-8866