Balance of Case Mix Monies Being Paid

Carl Pucci in Finance & Reimbursement

Members have reported seeing increases in their upcoming Medicaid payment, which reflects the balance of their January 2012 case mix adjustment, initially capped at 5%.  The payments will be processed in Medicaid check cycle 1876, dated 8/5/13 (release date 8/21/13).

EmedNY has confirmed processing $95M in retro monies to nursing homes, which includes the case mix balance that was initially withheld pending OMIG audit review. We will provide an update on subsequent CMI adjustments as well as related OMIG audit activity, following next week’s DOH briefing.



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