From the Office of the President: Universal Settlement Developments

Carl Pucci

An agreement has just been reached between the State of New York and legal counsels representing nursing homes on the terms of an $850 million universal settlement of most Medicaid rate appeals and reimbursement litigation. The agreement is subject to ratification by nursing homes, and the State is seeking to have responses from all facilities by 1/9/15.

A group comprised primarily of legal counsels representing nursing homes in various pending Medicaid rate litigation matters has concluded negotiations with officials from the Department of Health (DOH), Governor's Office, Division of the Budget and Office of the Medicaid Inspector General on the terms of a proposed universal settlement of outstanding nursing home litigation and rate appeals.  At this point, the term sheet is undergoing reviews and we expect a final version to be available by early next week. At that time, the term sheet along with facility payment amounts and other explanatory materials will be distributed to all nursing homes.  The State has signaled that the window for facilities to respond as to their participation will be very narrow, with responses due January 9, 2015.  With this timeframe in mind, the undersigned Associations will be holding an audio conference as soon as possible to review the settlement agreement terms with member facilities and respond to questions.  

The overall settlement would provide $850 million in additional payments to nursing homes over a five-year period.  In exchange for these payments, nursing homes in the State would have to agree to drop nearly all pending lawsuits and rate appeals involving rates in effect prior to January 1, 2012 (i.e., the implementation of statewide pricing) as well as some more recent rate matters, with certain exceptions.

The Associations are working to develop the package of materials, which will be issued to all facilities early next week. In the meantime, member facilities may want to review their outstanding appeals and lawsuits again in preparation for the State’s request for commitment to the settlement. Please be on the lookout for further communications next week.


New York State Health Facilities Association
Continuing Care Leadership Coalition
Greater New York Health Care Facilities Association
Healthcare Association of New York State
LeadingAge New York
Southern New York Association

Richard J. Herrick
President & CEO
518-462-4800 x11

Stephen B. Hanse, Esq.
Vice President & Counsel, Governmental Affairs
518-462-4800 x25

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