DOH Monthly Briefing – Finance – May 2017

Carl J. Pucci in Finance & Reimbursement

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

Bed Hold

With the elimination of the 50% reimbursement for hospital bed hold effective 4/1/17, numerous provider questions have arisen. NYSHFA and other statewide and regional associations have compiled a listing of questions which were presented to DOH last week. DOH is working on guidance (i.e. DAL) for both financial as well as programmatical issues raised, including a FAQ in response to the many operational questions raised by members.

A separate meeting on bed hold is tentatively being scheduled for this Friday between DOH rate-setting, DOH legal and provider associations to clarify the bed hold regulations and statute. DOH will stop all bed hold billings and remove the bed hold rate code in the very near future. They recognize that cross over claims billed and paid post 4/1/17 will be subject to recoupments, which also will be addressed in upcoming guidance.

2016 RHCF Software

The final software edits are being uploaded today, with the software expected to be released this week. The due date for the RHCF filing is expected to be 7/1/17.

Equity Withdrawal

The revised Equity Withdrawal form is expected to be finalized and posted within the next two weeks. DOH indicated the form has been simplified and will not require any additional information from providers seeking equity withdrawal approval.

Advanced Training Initiative (ATI)

DOH reported that 200 out of 229 eligible facilities completed the ATI survey, due yesterday 5/1/17. DOH will share the list of facilities who have not yet submitted the survey with the associations for further follow-up. The survey results will be reviewed at an upcoming ATI Workgroup meeting which will be scheduled later in May.

1% Restoration

DOH is in discussion with DOB, the Governor’s office and CMS with respect to the 1% restoration. They hope for some resolution later this month, but are not yet prepared to issue written guidance.

Medicaid Lag Reinstatement

DOH will share a listing of providers who are coming off the two-week Medicaid payment lag with the associations. All members should respond to any notifications received from DOH with respect to the lag, as they continue to evaluate providers on a case-by-case basis.

Universal Settlement (US)

DOH reiterated that year three funding of the US is included in the budgeted global cap, and that their intention is to pay this installment by 3/31/18, as per the settlement agreement.

Capital Webinar/Workgroup

DOH will conduct a capital webinar during late June, in advance of this year’s capital attestation period to address issues and concerns related to the 2016 attestation process. On a separate track, DOH will reform the Capital Workgroup to discuss capital methodology issues going forward. NYSHFA will utilize its Payment for Services Committee to bring capital issues forward in advance of both the webinar and the Capital Workgroup meeting.

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


Carl J. Pucci
Chief Financial Officer
518-462-4800 x36