DOH Monthly Briefing – Finance – February 2017

Carl J. Pucci in Finance & Reimbursement

DOH held its monthly briefing earlier today. The following summarizes the topics discussed:

Rate Packages

  • January 2017 Rates:  DOH issued the 1/1/17 rates a week or so ago, with expected payment date via cycle #2059, check release date of 2/22/17. Please see NYSHFA member mailing (1/31/17) for full details as well as the rate DAL.
  •  Cash Receipts Assessment (CRA) 2015:  DOH has acknowledged system errors related to the 2015 CRA, first disclosed via DAL issued last week. Corrections are slated to be in place by cycle #2061, check release date 3/8/17. DOH has outlined the correction process, which it shared with the Associations. NYSHFA is presently reviewing the information and will provide further details to members via a NYSHFA EXTRA in the next few days. Members are not required to take any further action at this time.

Minimum Wage

Per diem adjustments for the minimum wage have been included on line 13 of the 1/1/17 rate cover sheet. NYSHFA has requested clarification and supporting documentation of the payment methodology to ensure that reimbursement for the minimum wage increases approximate facility-specific DOH wage surveys. DOH will be sharing the payment methodology with the Associations, and has agreed to provide the facility-specific calculations. NYSHFA will update members once the data has been received.

Advanced Training Initiative (ATI)

The $46M funding for year 2 of the ATI has been processed through MFM (Medical Financial Management) via cycle #2056 (check release date 2/1/17.) DOH has scheduled a Workgroup meeting to discuss performance measures needed for compliance evaluation going forward. NYSHFA is conducting member conference calls this week to discuss training program options for eligible members. (Thursday, February 9, 2017 at 10:00 am is the next scheduled call.)

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 are slated to be paid by cycle #2057 (check release date 2/8/17.) The 2014 audits are currently being processed by OMIG, with draft audit reports being circulated to providers.

Medicaid Payment Lag

DOH is presently reviewing the list of providers currently off of the two-week Medicaid payment lag (through prior approved requests.) The required lag affects the Global Spending Cap, and as such, DOH will be making efforts to reinstate the lag for many of the estimated 100 facilities currently exempted. Letters will be sent to those facilities requesting financial documentation to support continued lag relief going forward. DOH will allow sufficient time for any facility brought back on the lag to adequately prepare for the resulting cash flow effect.

Equity Withdrawal

Letters will be sent to providers who have not received DOH prior approval for equity withdrawals over the 3% limit. The DOH letter will remind providers of the prior approval requirements as well as potential penalties associated with withdrawal violations. DOH will include equity withdrawal guidelines as part of a webinar related to capital issues currently being developed.

1% Restoration

As previously reported, the payment methodology to proportionally increase the direct and indirect prices has been approved by DOH, but still awaits CMS approval.

Capital Attestations

DOH will continue to review pending 2017 Capital Attestations through the end of the first quarter.

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


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