DOH Monthly Briefing – March 2020

Carl Pucci

DOH held its Monthly Briefing earlier today. The following summarizes the topics discussed: 

FFS Transition 

As previously noted, the implementation of the MLTC-FFS nursing home benefit limitation will not be preceding on either March 1 or April 1, 2020. Indications are a May 1, 2020 date has been set for long-term nursing stay residents to disenroll from MLTC plans. Once the DOH-coordinated batch disenrollment occurs, residents meeting the three-month threshold going forward will be disenrolled by individual plans. Guidance from OHIP – Division of Long-Term Care is expected within the next week or so.  The Associations have requested a separate briefing with OHIP to discuss the transition implementation. Members should continue to forward questions and concerns to NYSHFA and/or MLTCNH@health.ny.gov. 

January 1, 2020 Rates    

A DAL is expected next week which will provide guidance on the MDS data collection period based on the 7/31/19 census picture date, in preparation for the upcoming 1/1/20 rate issuance. 

1% Medicaid Cut 

As previously announced in NYSHFA member mailing dated 2/24/20, the 1% cut to Medicaid claims will become effective in upcoming Medicaid cycle #2219 (check release date of 3/18/20). The initial cut will be retroactive to 1/1/20. 

OMIG MDS Audits  

The 2016 final audit reports have been sent to Providers, as OMIG awaits responses. The 2017 field work is in mid-stream and initial reports will be issued in the next few weeks. 

COVID-19 

NYSHFA shared legislation and information on Washington State’s recent legislation for an enhanced rate for nursing homes.  The goal is to incentivize nursing homes to take difficult to place individuals who remain in hospitals for other reasons in order to free up hospital beds for coronavirus patients or other acute patients. As the outbreak continues to present challenges, innovative approaches will need to be explored often on short notice.

Remittance Recoupment Reports

The Associations requested that DOH interact with eMEDNY to ensure that Provider retroactive recoupment reports are released as soon as possible.

2019 RHCF

The RHCF software is expected to be released in early May, with a mid-July due date, similar to last year.

Bedhold Revised Regulations 

The revised bedhold regulations were adopted, effective 5/29/19 (see member mailing). NYSHFA has been compiling members' bedhold questions and has forwarded them to DOH. DOH is formulating a Frequently Asked Questions (FAQ) document. Members should continue to email any bedhold questions to both nfrates@health.ny.gov as well as to NYSHFA. 

PDPM 

DOH is reviewing the implications related to PDPM and will be seeking further input from stakeholders in the upcoming months ahead.

NYSHFA/NYSCAL CONTACT: