DOH Posts 2013/14 Rates

Carl J. Pucci in Finance & Reimbursement

DOH has posted revised Medicaid Rates for January 2013, April 2013 and January 2014.  These anticipated rates incorporate the July 2012 CMI adjustments, capped at 5% subject to OMIG audit.  Members should see the payment effects of these rates beginning with Medicaid cycle 1905 (check date 2/24/14, release date 3/12/14), as the rate calculations had been forwarded to EMEDNY prior to yesterday’s HCS posting.  Note that the July 2013 and January 2014 rates will eventually be updated to reflect the January 2013 CMI adjustments (currently awaiting DOB approval.)  DOH has indicated that these rates should be processed by the end of First Quarter 2014.  The Quality Pool adjustment is still awaiting CMS approval, and is not included in this rate package.  Members should also note the deadline for filing 2014 capital rate appeals for errors or omissions is June 26, 2014.

Attached are the respective DAL’s for both the 2013 and 2014 rates.

NYSHFA will continue to monitor rate-setting activity and provide updated timelines once they are known.

Director, Finance & Reimbursement
518-462-4800 x36