DOH Monthly Briefing – Finance – March 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

  • January 2017 Rates:

The rates were issued in late January, and include the updated July 2016 Case Mix, approved 2017 Capital Attestations, Minimum Wage adjustment and fully-implemented pricing methodology. DOH has also updated the benchmark rates accordingly.

Minimum Wage

Minimum wage adjustments were incorporated into the initial 1/1/17 rates (line 13). NYSHFA has received the statewide facility data file and will review member impacts as compared to their wage survey data in order to address any discrepancies.

OMIG Audits

OMIG has issued the 2014 draft audit reports. DOH announced that, effective with the January 2015 submissions, OMIG will no longer audit the MDS. DOH is drafting an RFP to determine a new audit contractor going forward. They will be seeking general Association input, clarification points and overall audit process improvements prior to going out to bid. NYSHFA will utilize its Payment for Services and Clinical & Quality Committees to gather the appropriate information requested.

Cash Receipts Assessment Reconciliation (CRA)

According to DOH, the 2015 CRA Reconciliation is now close to 100% correct. DOH is examining remaining provider recoupment issues on a case-by-case basis, and anticipates outlier issues to be corrected no later than cycle 2064 (check release date 3/29/17).

Equity Withdrawal

DOH has revised the Equity Withdrawal letter in the 2/23/17 DAL. It is anticipated DOH will be enforcing the notification requirements related to Equity Withdrawal, and letters will be sent out to those in violation over the next few weeks. DOH will share the draft letter with the Associations prior to sending, as well as a listing of facilities currently in violation. DOH has indicated it will not impose retroactive penalties at this time for those facilities found in violation of the notification requirement. The Equity Withdrawal form has been revised and will be posted to the HCS.

1% Restoration

As previously reported, DOH is still awaiting CMS approval. NYSHFA continues to strenuously lobby both DOH officials and the Legislature to release the state share portion of the funding.

Medicaid Lag Reinstatement

Letters have been sent to specific facilities who may be placed back on the two-week lag. DOH is evaluating facility responses accordingly. All members should respond if notified in order to prevent automatic placement on the lag.

Case Mix

The January 2017 MDS submission process will begin in the next week or so. Members are urged to submit accurate and timely MDS data to avoid delays in CMI adjustments in the upcoming July 1, 2017 rates.

Advanced Training Initiative (ATI)

DOH will survey eligible facilities receiving funds from this year’s ATI. The survey will seek information on facility training efforts to date, and request five employees individually respond from each facility. NYSHFA will have input to the survey in advance of finalization.

Quality Pool

The 2013-15 Quality Pool distribution continues to be delayed pending litigation. Note:  The 2016 NHQI results have been posted to the HCS.

Capital Attestations

Work continues to approve remaining outstanding Capital Attestations. 4/1/17 is the anticipated deadline for final review.

Refinancing/Shared Savings

DOH expects to release its’ Policy & Procedures in the next few weeks. All approved refinancings after 4/21/15 are eligible to be considered for shared savings. DOH indicated it is current with all refinancing applications and anticipates a 30-day turnaround on future refinancing applications.

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


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