DOH Monthly Briefing - September 2020

Carl J. Pucci

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

January 1, 2020 Rates 

DOH has released the 1/1/20 rates which include the updated attested capital component. The case mix has not yet been updated to reflect the 7/31/19 census picture date, pending finalization of the current MDS submission process. The 1/1/2020 rates will then be revised to include the updated case mix adjustment. These rates are currently under executive review.

July 2020 CMI 

DOH noted that the timeline for the upcoming July 2020 MDS collection period will be released very shortly after the current January 2020 MDS submission process is finalized.

MLTC to FFS Transition 

OHIP released additional guidance yesterday (see NYSHFA Now member mailing) related to the MLTC Nursing Home Benefit Limitation, which was implemented on 8/1/20. NYSHFA had raised member concerns regarding residents that met the criteria for disenrollment but were not included in the initial 8/1/20 DOH batch disenrollment process.

DOH is implementing a second “batch disenrollment” process in which affected residents will convert to FFS on 11/1/20. Members are required to provide DOH additional residents information by 9/21/20 (as outlined in the above member mailing guidance). Members should continue to forward transition questions and concerns to

ALP – Minimum Wage Adjustments 

As noted in last Friday’s NYSCAL Notes member mailing, DOH has reversed earlier minimum wage calculations for 2017 and 2018 due to data concerns. (effective in upcoming Medicaid cycle #2247 …...9/30/20 check release date). DOH will send notification information to ALP providers once the minimum wage calculations have been verified and the revised adjustments are ready to be issued. 

COVID -19 

NYSHFA had previously raised the question of appropriate Medicaid reimbursement for the Executive Order mandating biweekly employee testing. DOH is still discussing internally and will communicate guidance when a decision has been reached. 

2021 Capital Rates 

With the RHCF deadline extension this year to 9/15/20, DOH is not yet able to forecast the timing of the 2021 capital rate attestation process. Further information will follow. 

OMIG -MDS Audits 

OMIG continues work on finalizing the 2016 MDS audits and is beginning to issuance final audit reports. The 2017 audits will resume once other state agency COVID-related requirements are met. OMIG recognizes the stress that providers are currently facing and will “work with facilities” as they begin commencing future MDS audits. They plan to request provider information electronically vs. on-site visits at this time. 


The associations have asked for clarification on whether the federal stimulus funds and/ or PPP loan disbursements would be subject to the cash receipts assessment. DOH continues internal discussions, but as yet does not have any further guidance. 

NYSHFA will continue to keep members updated on these rate-setting issues as they develop. 


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