Capital Streamlining/Refinancing Shared Savings Workgroup

Carl J. Pucci in Finance & Reimbursement

NYSHFA participated in a dual focused workgroup meeting last week involving DOH initiatives to streamline the capital rate process, as well as establish a shared savings program for SNF providers.

Capital Streamlining

Providers would have a greater involvement in the capital rate calculation prior to the rates being issued.  Analysis and attestation by providers of their capital rate prior to rate issuance should eliminate most capital appeals.  DOH will provide a training webinar, develop the provider attestation form and define clear capital reimbursement policy.  DOH will also establish timelines and engage OMIG to discuss the scope of their involvement going forward.  NYSHFA will assist in providing common capital reimbursement issues, as well as provide input to capital policy decisions.

Refinancing Shared Savings

Language has been adopted in the 2015/16 Executive Budget to establish a shared savings initiative for mortgage refinancings, still subject to CMS approval.  Pre-approved eligible refinancings after 4/1/15 would automatically be reimbursed 50% of the related interest savings.  DOH will develop a database to track specifics of all eligible refinancings, and the cost report would reference both the base financing and refinancings schedules.

The associations expressed concerns with the current delays in DOH approved mortgage refinancings.  In response, DOH will determine how to expedite approvals within a 30 day process going forward.  Requests to include mortgage insurance and letter of credit fees in the shared savings program were also presented to DOH.

NYSHFA’s Payment for Services Committee will continue to play a key role in providing input to DOH over the coming months on both initiatives.


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