NYSHFA Discussions with DOH are Successful in Delaying Therapy Changes to Medicaid MDS Assessment

Carl Pucci Nancy Leveille and Karen Morris in Finance & Reimbursement

NYSHFA met with top DOH officials to advocate for members to have appropriate Notice of Changes to the Medicaid only assessment process before changes are implemented. We received written notice on Friday that they have agreed with our request and will apply the changes they announced in October to the current assessments beginning October 2014, and reversed their decision to implement the O0420 and RUG scoring retroactively.  According to DOH, postponement of the therapy implementation resulted in a $4M statewide cost (i.e., provider savings) in 2014.  Members are urged to verify that these therapy changes are now in place with their software vendors.  See the attached DOH letter for more details.


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

Nancy Leveille, RN, MS
Sr. Director, Member Operational Support
518-462-4800 x20

Karen Morris, RN, MS
Director, Clinical & Quality
518-462-4800 x15