Dear Administrator Letter

  • Letter is also available in Portable Document Format (PDF)

February 6, 2020

Dear Administrator:

This letter provides you with information regarding your Residential Health Care Facility (RHCF) reimbursement rates effective July 1, 2019. These rates have been promulgated in accordance with section 2808 (2–c) of the Public Health Law.

The all–inclusive rates provided on Health Commerce System (HCS) via the Healthcare Financial Data Gateway have been updated to include a case mix adjustment for the January 2019 collection. These rates contain an adjustment to limit the impact for any facility that reported a case mix change of greater than plus or minus five percent from the July 2018 collection. Additionally, these rates include the updated 2% penalty on poor performing Nursing Homes, effective January1, 2019.

As per a letter sent on December 6, 2019, all providers were taken off the Medicaid lag (effective with cycle 2207) and will be returned to the lag now that the July 2019 rates have been recalculated. The payment for July 2019 rates will be made in cycle 2217, with a check release date of February 26, 2020. The table below shows how the reinstatement of the two­ week lag will be implemented.

Cycle # EMedNY Check Date Current Check Release Date Revised Check Release Date Status of Lag, Reinstatement
2217 2/17 2/19 2/26 1 week
2218 2/24 2/26 3/4 1 week
2219 3/2 3/4 3/18 2 weeks
2220 3/9 3/11 3/25 2 weeks

If you have any questions regarding the rates, please send an email to MDS_BRHCR@health.ny.gov and staff will respond to your inquiry.

Sincerely,

Ann Foster
Deputy Director
Division of Finance and Rate Setting
Office of Health Insurance Programs