DOH Posts Important Health Care Worker Bonus Updates
In accordance with their commitment to provide weekly updates, the Department of Health (DOH) updated information regarding the Health Care Worker Bonus (HWB) Program on Mon., Aug. 29th. The update includes additional Frequently Asked Questions (FAQs) as well as a new set of presentation slides. Rather than scheduling a webinar, DOH will be posting new information to the website in the form of presentation slides and updates to FAQs, with the next posting. Newly added FAQs are highlighted in yellow. The Department hopes to post the next set of slides and updated FAQs by the end of this week.
In recognition of the tight Sept. 2nd timeframe for filing claims for the first vesting period, DOH is offering employers a grace period. While urging employers to make all efforts to submit claims for the first vesting period by the due date, DOH is indicating that it will be possible to submit claims from the first vesting period that were not able to be submitted by Sept. 2nd during the second claim submission period (i.e., Oct. 1st – Oct. 31st).
The update makes several key clarifications as well as some significant changes to the program. Some of these changes result in additional questions, which LeadingAge NY is submitting to DOH. We urge members to review the new materials and to share any new questions that may arise. Major changes and clarifications include the following areas:
- Contract Staff: Prior to the Aug. 29th FAQ update, DOH HWB materials indicated that, other than independent contractors who contract directly with the employer, contract and agency staff were not eligible for the bonus. While the FAQ indicating the restriction has not been removed from the FAQ document (top of p. 4), content in the slides (p. 12) and in a new FAQ (p. 13) indicate that contract staff may receive the bonus (provided they meet other eligibility requirements). It places the responsibility for claiming the bonus for contract staff on the qualified employer (i.e., health care facility/provider), not the contract agency. It also requires the qualified employer to document that the worker “was employed” for the full vesting period. This change prompts many questions, including payment logistics, some of which we have submitted to DOH. The new FAQ is copied below.
Q. Are contract staff eligible for the bonus? If they are, who is responsible for submitting these staff for a bonus? For example, if a hospital employs staff that fall under one of the eligible titles but are co-employed with a non-healthcare entity, are they eligible for the bonus?
A. Contract staff in eligible titles may receive the HWB assuming all other requirements are met. For the purposes of the HWB program, qualified employers that have engaged in staffing arrangements to obtain workforce services (PEOs, and other third-parties) for employees engaging in front- line-hands on health care services in eligible employee titles are eligible for the HWB. The qualified employer, not the contracted agencies, must submit bonus claims for staff that perform work for the qualified employer under such arrangements and that otherwise meet the eligibility criteria to be an eligible employee.
The qualified employer is required to maintain records that demonstrate the employee was employed for the full vesting period. All qualified Medicaid employers must maintain contemporaneous records tracking all claims submitted for no less than six (6) years. The qualified employer must furnish such records upon request to the department, the Office of Medicaid Inspector General (OMIG), the US Department of Health and Human Services, and the deputy attorney general for Medicaid Fraud.
- Terminations: Prior to the Aug. 29th update, several FAQs focused on employer responsibilities to former employees, but all described resignation scenarios. In our responses to member questions, we suggested that when it came to the obligation to pay the bonus, voluntary separations and terminations were treated in the same way. The most recent FAQs (p. 20) contain a table that clarifies that individuals who are terminated by the employer after vesting ARE eligible for the bonus. While the table provides a number of scenarios, the rule seems to be that if an eligible employee was terminated after vesting, regardless of when that termination occurred, that employee is eligible for the bonus. For employees who resign, if that resignation occurs prior to the deadline by which the bonus is due to the employee (i.e., 30 days after receipt of the bonus payment by the employer from the State), the employer is not obligated to make the payment.
- Average Hours: The new materials contain a discrepancy between the slides and the FAQs regarding how overtime hours should be treated when employers calculate average weekly hours. While the FAQs (p. 11) state that employers SHOULD include overtime hours, the slides (p. 10) indicate the opposite. We are awaiting clarification from DOH and hope that it does not result in providers recalculating hours needlessly.
Some of the other topics that are addressed in the new FAQs/slides include:
- Managers: Management and supervisory staff are not automatically excluded due to supervisor title. They may be eligible if their job activities qualify.
- Differentials: DOH clarified that shift differential payments (paid as one-time lump sum payments or as an add-on) should be considered in the calculation of the employee’s annualized base salary.
- Employer Eligibility: DOH clarified the criteria an eligible Medicaid employer must meet. Along with being an enrolled Medicaid provider that bills for Medicaid services and has at least one eligible employee, they must meet at least one of the following conditions: be listed as an eligible provider or facility type in the statute OR be subject to the certificate of need (CON) process OR serve at least 20 percent Medicaid enrollees.
- Health System Employees: DOH clarified that employees of a health system that has a Medicaid Management Information System (MMIS) ID that is linked to other employers within the system would be considered continually employed even if they were to move to different employment within that system. The FAQ is copied below.
Q. Our system is comprised of multiple employers versus only one employer. An employee who leaves one employer (part of our network) to go to another employer within our network, the employee would not be qualified due to not having continuous employment with the same employer. Is that accurate?
A. If the health system has an MMIS ID that is linked to the other employers within the health system, the employee will be eligible even if they transition to another employer within the same health system. If the health system is comprised of separate individual entities with unlinked MMIS IDs, the employee would not be eligible if they leave from one employer to another during the respective vesting period.
The new FAQs also include several questions focusing on enforcement that seem unreasonably harsh given the information gaps and last-minute program changes. They indicate that inappropriately made bonus payments would be recovered from the employer, but that the employer would have no right to recover an inappropriately paid bonus from the employee. While LeadingAge NY will fight for a reasonable approach to enforcement, especially in this first round, it is important for providers to document and keep information indicating the DOH guidance they used to make decisions where clear guidance was unavailable.
Please note that the information above is not exhaustive of all of the updates made to the FAQs and contained in the slides; we urge members to review those materials directly as well.
The direct link to the slide deck is here.
The direct link to the updated FAQs is here.
The DOH dedicated email address for HWB Program questions is NYSWorkersBonus@health.ny.gov. The Department’s HWB Call Center is aimed at answering questions about the online claims portal and assisting qualified employers with submitting their claims (1-866-682-0077).
We thank members for all of your work on this initiative and for your continued patience with this often frustrating process. We encourage you to continue to submit questions to us while also submitting questions on atypical situations to DOH. Please note that we have submitted many questions to DOH on behalf of our membership, including additional questions raised from our member webinar. Many of our questions remain outstanding, and we will continue to seek answers and advocate for your key member issues.
Contact: Darius Kirstein, dkirstein@leadingageny.org, or Diane Darbyshire, ddarbyshire@leadingageny.org. Both can be reached at 518-867-8383.