DOH Monthly Briefing – Finance – January 2017

Carl J. Pucci in Finance & Reimbursement

DOH held its monthly briefing earlier today. The following is a brief summary of the topics discussed:

Rate Packages

Updates to the following rate packages were noted by DOH: 

  • January 2017 rates:

The rates, which now include the fully-implemented pricing methodology, will also be updated for July 2016 Case Mix, approved 2017 Capital Attestations, and the Minimum Wage adjustment. The rates have been approved by DOB and are expected to be posted in the next few weeks.

  • Cash Receipts Assessment (CRA):

The 2015 CRA has been approved by DOB. The estimated statewide impact to providers is $20M, and is expected to be posted this January.

Advanced Training Initiative (ATI)

The $46M in funding for the ATI is being processed through MFM (Medical Financial Management). Payments should be expected in cycle 2056 (check release date 2/1/17). DOH will schedule a meeting in the next few weeks to discuss related metrics.

Minimum Wage

The rate adjustment attributable to the minimum wage methodology, (still pending CMS approval), will be incorporated into the January 1, 2017 rate package for both SNFs and ALPs. Rate adjustments will be incorporated into the miscellaneous adjustment line on the rate sheets. The minimum wage workgroup will reconvene in early 2017 to discuss preparations for the April 2017 rate impacts.

Capital Attestations

DOH received 340 capital attestations, and have approved approximately 200 to date, with 90 rejections. The remaining attestations were not reviewed due to time constraints. DOH has released capital discussion points as well as proposed capital processing options going forward (attached). Note: The Capital Attestations will be mandatory for all providers next year.  A webinar will be upcoming regarding the attestation process.

OMIG Audits

The 2012 adjusted audit rates have been paid. The 2013 audited rates (effective 7/1/13 and 1/1/14) have been approved by DOB and will be going to EMEDNY for processing over the next few weeks.

DOH and OMIG are expected to release further MDS audit guidance to better assist facilities with their MDS submission process.

1% Restoration

As previously reported, the payment methodology which would proportionally increase the direct and indirect prices, has been approved. DOH is still awaiting CMS approval prior to sending on to DOB.

Quality Pool

2013 – 2015 Quality Pool continues to be delayed pending litigation.
Note:  The 2016 NHQI results are being posted to the HCS. Look for a separate NYSHFA member mailing tomorrow with more details.

Equity Withdrawal

DOH reviewed the 2014 RHCF, and cited an increasing number of equity withdrawals without prior approval. The 1/1/17 rate DAL will contain “reminder language” outlining the equity withdrawal requirements. DOH will next compare 2015 RHCF data to 2014’s, prior to potential further action.

NYSHFA will continue to keep members updated on these issues moving forward.


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