No Nursing Home Medicaid Payments This Week
As part of the process of returning Medicaid payments to the two-week lag, nursing homes will receive no Medicaid fee-for-service (FFS) payments during the week of Feb. 19th. Cycle 2217, with a check date of Feb. 17th, will be released on Feb. 26th. Note that this cycle will include adjustments reflecting the updated July 2019 rate retroactive to July 1, 2019. To expedite the reversal of the previously retracted July 2019 rates, non-specialty nursing homes were removed from the two-week Medicaid payment lag. Because this resulted in homes receiving four weekly Medicaid payments over the course of two weeks, returning to the lag requires providers to endure two weeks when no payments are made. The week of March 11th will be the second week during which no Medicaid checks will be released for nursing homes.
Homes that had not finalized or certified their census roster submissions by the requested date may not yet have an updated July 2019 rate sheet available. Members who are not able to locate their updated July 2019 rate sheet on the Health Commerce System (HCS) should contact the Department of Health (DOH) at nfrates@health.ny.gov. Please be sure that you are on the Healthcare Financial Data Gateway section of the HCS when accessing current rate sheets. The Dear Administrator Letter (DAL) associated with the rates is available here. Along with updating the case mix index (CMI) using data based on a Jan. 30, 2019 picture date, these rates also reflect an updated 2 percent poor quality penalty for those homes subject to the penalty.
Providers should have seen an adjustment in Medicaid payment cycle 2215 (check date of Feb. 3rd) reflecting reconciliation of the 2018 cash receipts assessment and should anticipate a negative adjustment in Medicaid payment cycle 2219 (check date of March 2nd, scheduled release date of March 18th) reflecting the 1 percent across-the-board cut retroactive to Jan. 1, 2020. The 1 percent reduction impacts payments for service dates starting on Jan. 1st and going forward.
Nursing homes who have applied to share in Medicaid savings resulting from qualified mortgage refinancing arrangements should watch the HCS for document postings and updated rate sheets reflecting the shared savings payments. A DOH letter on this topic issued last week is available here.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841