Census Roster Upload Period Starts Oct. 3rd
The window to submit census rosters that the Department of Health (DOH) will use for analysis and case mix adjustment of January 2019 Medicaid rates begins on Oct. 3rd and ends on Oct. 26th. The rosters are uploaded through the Health Commerce System (HCS). Roster certifications must be submitted through email by Oct. 31st. The Dear Administrator Letter (DAL) notifying providers of picture and upload dates is available here. DOH issued a related DAL more recently (available here) specifying the type of manual assistance with roster-to-assessment matches that DOH would provide. Members that have a resident listed on a roster who does not match to a submitted MDS assessment, especially if the resident's payer was a Medicare Advantage plan, should contact DOH for assistance.
Unlike previous years when DOH collected MDS assessments associated with the last Wednesday of the prior July, the State is collecting rosters associated with two picture dates: April 25th and July 25, 2018. DOH has stressed that they are doing this to facilitate analysis, and there has been no determination on how data from the two picture dates will be blended for purposes of determining the case mix index (CMI) for January 2019 rates. It is unclear whether this methodology will be adopted going forward; DOH still intends to eventually convene a workgroup to discuss how case mix collection will be handled in the future.
The State is making this change due to concern about case mix growth and to implement a provision included in the enacted state budget that requires an annual CMI-related savings of $15 million. LeadingAge NY will continue to work with DOH to ensure that Medicaid rate decreases driven by this change are mitigated and to share information that would allow providers to budget for the impact as soon as possible.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841