DOH Monthly Briefing – Finance – November 2016

Carl J. Pucci in Finance & Reimbursement

DOH held its monthly briefing earlier this afternoon. The following is a brief summary of issues that were discussed:

Minimum Wage

The payment methodology is at DOB awaiting final approval, and regulations are still being finalized. CMS must also still approve the State Plan Amendment. It is DOH’s intention to process the minimum wage adjustment in the upcoming January 2017 rates. (see below). Approximately $9.1M would be allocated based on a WEF-adjusted regional pricing methodology.

2017 Notice Rates

2017 Notice Rates were issued last week, which included the initial 2017 capital rates, DOH expects to issue the final rates on or around 1/15/17, and should include approved capital attestations, the updated July 2016 casemix, as well as the minimum wage adjustment (assuming CMS approval is in place).

MDS Case Mix

The July 2016 MDS data submission is being completed. DOH noted that approximately 53 facilities have missing or incomplete MDS data (from the October catchment period). DOH is reviewing CMI regulations and is convening another meeting next week with the Associations to determine how to treat what they perceive is a chronic facility reporting issue. Options may include issuing a default rate and/or holding those facilities back as a separate rate package, so as not to penalize the over 550 facilities who successfully uploaded their MDS data in a timely manner.

OMIG Audits

2012 OMIG Audits are now finalized and to DOH executive staff for review. 2013 audit data has left OMIG and is now with DOH rate-setting. DOH will release Medicaid payment cycles once they have been established.

Cash Receipts Assessment (CRA) – 2015

The 2015 CRA is due to be processed in early December. DOH will continue to roll the 2014 base payment into the 2017 rates going forward.

1% Restoration

The CMS SPA has been filed, and all requests for additional information have been responded to by DOH. Appropriate regulations are in place. DOH will be sharing a draft rate run with the Associations, as well as a summary of the payment methodology. No timetable was given regarding the release of the monies ($140M for 2014/15 and $70M for 2016).

Quality Pool

The regulations and CMS SPA have been approved for 2013, however, pending litigation continues to delay processing.

Advanced Training Initiative (ATI)

DOH expects payment for the ATI Year-2 funding to occur in December. The ATI Workgroup will be meeting next week to discuss performance metrics in an effort to satisfy CMS requirements, and as a necessary step in advancing the ATI further (presently only approved for 2 years).

2017 Capital Attestations

2017 Capital Attestations are due on December 2, 2016. No extensions will be granted. Facilities with specific issues concerning the attestation process are urged to email DOH ASAP.

Equity Withdrawal

The Governor’s office has requested that DOH review equity withdrawal data (from 2014/2015 RHCFs), to assure adherence to the equity withdrawal regulations and prior notice requirements. NYSHFA will be in discussions with DOH to gather further information.


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