DOH Issues 1/1/17 Medicaid Rates

Carl J. Pucci in Finance & Reimbursement

DOH is publishing the initial January 1, 2017 Medicaid rates. The rates are expected to be paid in cycle #2059, check date 2/6/17, check release date 2/22/17. The DAL and related attachments outline the primary rate components which include: 

  • Operating Component – direct and indirect pricing component (now 100% fully-phased in).
  • CMI Adjustment– reflects the July 2016 MDS census collection.
    • 5% ceiling/floor cap remains in place pending OMIG MDS audit.
  • Minimum Wage Adjustment– reimburses mandatory minimum wage increases beginning 1/1/17.
    • Reflects SNF wage survey data, adjusted regionally
    • Reimburses direct salary cost increases and related fringe benefits
    • Requires aggregate additional funds be directly associated with statutory minimum wage increases
    • Dependent upon CMS approval
    • Subject to OMIG audit
  • Capital Component – reflects 2015 RHCF costs, as well as approved capital attestations. Pending attestations (if approved) to be incorporated in upcoming rates.
  • Withdrawal of Equity – reminder that Public Health Law requires prior DOH approval via Equity Withdrawal/Transfer of Asset Request form.
  • Rate Appeal Process – facilities have 120 days to file appealable components of the rate.
  • Members are urged to carefully review each DAL attachment to ensure accuracy of their rates, as well as maintaining DOH compliance for both the Minimum Wage and Equity Withdrawal requirements.

Any questions should be referred to nfrates@health.ny.gov

NYSHFA CONTACT:

Carl J. Pucci
Director, Finance & Reimbursement
518-462-4800 x36