New York Not Collecting MDS Section GG Data in OBRA Assessments

According to the New York State Minimum Data Set (MDS) coordinator, the State is not electing to begin capturing Section GG data in Omnibus Budget Reconciliation Act (OBRA) comprehensive and OBRA quarterly assessments beginning Oct. 1, 2020, nor is there currently any timeframe for doing so.

MDS Version 1.17.2 is now in use, effective Oct. 1, 2020. The Centers for Medicare and Medicaid Services (CMS) had indicated in May 2020 that in response to State Medicaid Agency and stakeholder requests, the MDS 3.0 item sets were updated with changes to support the calculation of Patient-Driven Payment Model (PDPM) payment codes on OBRA assessments that are not combined with the 5-day Skilled Nursing Facility Prospective Payment System (SNF PPS) assessment. Calculation of PDPM payment codes on OBRA assessments is not possible with the current MDS item set Version 1.17.1.

This was seen as a logical step in the planned elimination of MDS Section G that was planned for this fall but has since been postponed until two years following the current COVID-19 public health emergency. CMS noted that Version 1.17.2 will allow State Medicaid Agencies to collect and compare Resource Utilization Group (RUG)-III/IV payment codes to PDPM codes and thereby inform their future Medicaid payment models.

Reportedly, nearly 30 states are transitioning to requiring Section GG data to be captured for all OBRA assessments, but New York State is not among them. LeadingAge NY will continue to monitor the situation and advise members of further developments.

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