DOH Issues January/April 2020 Rates

Carl J. Pucci in Finance & Reimbursement

DOH has posted the January 1, 2020 and April 2, 2020 rates to the HCS system ...

Medicaid Update - July 2020

Carl J. Pucci in Finance & Reimbursement

The Office of Health Insurance Programs of the New York State Department of Health has approved the release of the July 2020 Medicaid UpdatePlease find the full current issue as a PDF (Portable Document Format) file available to be downloaded at ...

Nursing Home COVID-19 Fiscal Survey

Carl J. Pucci in Finance & Reimbursement

Earlier today, the survey notification below was emailed to members: 

Early in the pandemic, statewide associations surveyed nursing home members to collect some preliminary data on the financial impact of COVID-19.  With the emergency continuing, with the addition of staff testing costs, and with mounting revenue losses, we are seeking to update the impacts to better reflect the current financial realities.  The survey asks for information on COVID-related costs for staffing, supplies and materials as well as the impact of lost revenue due to reduced census. Your participation will provide us with critical insights for advocacy during what is likely to be a critical and challenging time.  Although the listed due date is August 21, we urge any member who is able and willing to complete the survey by Friday, Aug. 7th to do so.  Such responses will provide insights that will inform our testimony in the upcoming NY State Legislative hearings.  A PDF of the survey is also attached for your file reference.

The survey is due FRIDAY, AUGUST 21, 2020. We strongly urge member participation. Please direct survey questions to cpucci@nyshfa.org

https://www.surveymonkey.com/r/NH-COVID-19-SURVEY

Thank you for your efforts during this very difficult time. 

NYSHFA/NYSCAL CONTACT:

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

MDS Case Mix Match

Carl J. Pucci in Finance & Reimbursement

A reminder that DOH will be extracting the MDS data for the July 31,2019 census date this coming Wednesday, 7/1/20. Facilities should have reviewed their census data and submitted any MDS data revision’s to DOH. Members should ...

Provider Relief FAQs / Medicaid Allocation Webinar

Carl J. Pucci in Finance & Reimbursement

AHCA has released updated Provider Relief Fund FAQs, as well as an HHS notice of a Medicaid allocation application webinar to be offered Thursday, June 25, 2020. Below is the AHCA bulletin ...

MDS Webinar – Follow-up

Carl Pucci Lisa Volk and Nancy Leveille in Finance & Reimbursement

DOH has posted the MDS webinar slide deck for your reference (see MDS Case Mix Collection tab). A reminder that the deadline for review of census data and/or any MDS revisions is Sunday, June 28, 2020. Attached is ...

DHHS Offers Medicaid Allocation Application Tutorials

Esq. Stephen B. Hanse in Finance & Reimbursement

AHCA/NCAL is reporting that the DHHS CARES Act Provider Relief Fund Medicaid Application Process, while a positive step, also has come with an array of questions and concerns. Unlike Tranches 1-3, the Medicaid Allocation requires ...

A Long Term Care Update from AHCA/NCAL

Carl J. Pucci in Finance & Reimbursement

Attached is an update from AHCA/NCAL on long term care issues such as NHSN Report and Citations, COVID-19 Regulatory issues and COVID-19 Financial & Billing issues ...

AHCA: COVID-19 Update #78 | Relief Fund Portal for Medicaid Providers Launches

Carl J. Pucci in Finance & Reimbursement

On June 10, the U.S. Department of Health and Human Services (HHS) launched a web application portal for Medicaid providers other than SNF Medicaid providers. SNF Medicaid-only providers already should have received a Medicaid Allocation or will receive payments over the course of the week ...

HHS Releases $15 Billion for Medicaid Provider Relief

Carl J. Pucci in Finance & Reimbursement

HHS announced distribution of an additional $15 billion specifically for Medicaid providers who have not yet received funding from the Provider Relief Fund general allocation. These providers would include Assisted Living communities, other home and community-based service providers, as well as Medicaid-only SNFs ...

MLTC Transition to FFS

Stephen Hanse and Carl Pucci in Finance & Reimbursement

DOH held a conference call earlier today to announce the implementation of the MLTC-FFS three-month benefit limitation, which is now scheduled to take place effective 8/1/20Attached is the sample “Notice of Long-Term Care Medicaid Plan Disenrollment” which will be sent to SNF residents. DOH has ...

AHCA: COVID-19 Update #77

Carl Pucci and Jackie Pappalardi in Clinical & Quality, Finance & Reimbursement

In this COVID-19 Update:

  • AHCA Focuses on COVID-19 in SNF PPS Proposed Rule Comments
  • Economic Impact Payment Guidance
  • FDA Removes Many Respirators Manufactured in China from Approved List for Decontamination 

AHCA: Update #75 | HHS Releases Guidance on Important CARES Fund Questions

Carl J. Pucci in Finance & Reimbursement

Last evening, DHHS released long-awaited FAQs on Tax Identification Numbers (TIN), corporate structure and related transfers of funds. Other topics included explanations regarding additional requests of financial information, and guidance on executive compensation. With this release ...

HHS Clarifies June 3 Attestation Deadline

Carl J. Pucci in Finance & Reimbursement

HHS has clarified the June 3 Attestation deadline for providers to submit revenue data. Providers who have received a Tranche 1 allocation and are requesting additional Tranche 1 funding must provide their financial information by 6/3/20 ...

AHCA SNF Therapy Telehealth Under COVID-19 Section 1135 Waivers FAQs

Carl J. Pucci in Finance & Reimbursement

Attached is an AHCA FAQ related to the impact of yesterday's CMS therapy telehealth FAQs that clarified that facilities can furnish outpatient therapy telehealth services during the Public Health Emergency (PHE) ...

HHS Releases $4.9 Billion to SNFs

Carl J. Pucci in Finance & Reimbursement

HHS will disburse $4.9 Billion to SNFs from the Provider Relief Fund by the Cares Act. Providers will be paid electronically where possible, via a fixed and variable payment methodology. Each SNF will receive ...

EMEDNY to Implement Medicaid Payment Reduction

Carl J. Pucci in Finance & Reimbursement

EMEDNY has alerted all Medicaid providers that the recently enacted Executive Budget across-the-board cut of 1.5% on Medicaid payments will be implemented beginning with Medicaid cycle #2231 (check release date of 6/10/20). This equates to ...

HHS Updates Cares Provider Relief FAQs

Carl J. Pucci in Finance & Reimbursement

HHS has posted an updated set of Provider Relief Fund FAQs, as well as a state-specific database of providers who have received payments to date from the general fund. The AHCA bulletin with further details is below ...

AHCA: COVID-19 Update #69 | Reimbursement and Legal Issues Related to COVID-19 Testing in Long Term Care

Carl J. Pucci in Finance & Reimbursement

AHCA has received many questions from members on reimbursement and legal issues related to COVID-19 testing in LTC.  Responses to common member questions are included below ...

NYS Files 1115(A) COVID-19 Demonstration Waiver

Stephen Hanse Carl Pucci Jackie Pappalardi in Finance & Reimbursement

DOH has filed a request for Section 1115(A) Demonstration Authority related to the COVID-19 Public Health Emergency. The Waiver, which would be retroactive to March 1, 2020 and continue through March 31, 2021 requests $2.75 billion to fund mission-critical activities over this time span. To address the immediate pandemic needs ...

DOH to Initiate 1/1/20 Rate Package

Carl J. Pucci in Finance & Reimbursement

DOH has indicated it will be initiating the January 1, 2020 Rate Package, which will begin with submission of the MDS collection period based on the 7/31/19 census picture date. DOH is drafting a DAL which will outline ...

AHCA/NCAL Release Financial Guide/COVID Cost Calculator

Carl J. Pucci in Finance & Reimbursement

AHCA/NCAL has released a members only Grant & Loan management guide, a COVID-19 related loss and cost calculator, and an updated accelerated payments FAQ’s. The purpose is to offer a basic tool for members to assess allowable Medicare and Medicaid costs (pre-COVID) and compare such reimbursements to shortfalls where grants and loans fill funding gaps. This tool will be particularly useful with reporting on and documenting use of the CARES Act Provider Relief Fund grants. Below is the AHCA/NCAL bulletin ...

AHCA: COVID-19 Update #50 | Additional $20 Billion to be Distributed to Medicare Providers Today

Carl J. Pucci in Finance & Reimbursement

Explanation of the HHS Formula for Distribution of Provider Relief Funds - HHS allocated another $20 billion today to all Medicare providers. You may have received a check already and if not, you should over the next week. HHS intends to send checks to Medicaid-only providers but is not doing so in this payment. AHCA will continue ...

AHCA: COVID-19 Update #49 | Congress Approves Additional $75 Billion for Provider Relief Fund

Carl Pucci and Lisa Volk in Clinical & Quality, Finance & Reimbursement

Today, the House approved and the President is expected to quickly sign the Paycheck Protection Program and Health Care Enhancement Act, a bill that was passed by the Senate this week. The bill provides ...

CLARIFICATION: COVID-19 Update #47 | Additional Distribution of Provider Relief Funds

Lisa Volk and Carl Pucci in Clinical & Quality, Finance & Reimbursement

This is a clarification from yesterday’s member mailing on AHCA’s Update #47 regarding Additional Distribution of Provider Relief Funds ...

Provider Relief Funds – Updated FAQs

Carl J. Pucci in Finance & Reimbursement

AHCA/NCAL’s FAQs on the Provider Relief Fund has been updated to include information on the additional funding to be released this week. AHCA will continue to update the FAQ, as an increase of $75 billion is expected to pass the House and be signed by the President today ...

CMS NEWS ALERT: April 21, 2020 (COVID-19)

Lisa Volk Jackie Pappalardi and Carl Pucci in Clinical & Quality, Finance & Reimbursement

Here is a summary of recent Centers for Medicare & Medicaid Services (CMS) actions taken in response to the 2019 Novel Coronavirus (COVID-19), as part of the ongoing White House Task Force efforts ...

Medicare Relief Funds – FAQs

Carl J. Pucci in Finance & Reimbursement

AHCA has compiled frequently asked questions related to the initial $100B of Medicare relief funding to hospitals and other healthcare providers. Guidance related to recent member questions involving missing facility funding can be found under question #7 in the attached document ...

AHCA: HHS Releases a Portion of the $100B COVID-19 Health Care Fund

Carl J. Pucci in Finance & Reimbursement

AHCA is pleased to report that HHS has now announced the distribution of the first $30 billion of the $100 billion stimulus fund. A brief description of their process can be found here. Highlights are the following ...

CMS Approves Approximately $34 Billion for Providers with the Accelerated/Advance Payment Program for Medicare Providers in One Week

Jackie Pappalardi and Lisa Volk in Clinical & Quality, Finance & Reimbursement

The Centers for Medicare & Medicaid Services (CMS) has delivered near $34 billion in the past week to the healthcare providers on the frontlines battling the 2019 Novel Coronavirus (COVID-19). The funds have been provided through the expansion of the Accelerated and Advance Payment Program to ensure providers and suppliers have the resources needed to combat the pandemic ...

Reminder – Nursing Home COVID-19 Fiscal Survey Due

Carl J. Pucci in Finance & Reimbursement

A reminder that the nursing home COVID-19 Preparedness and Response Fiscal Survey is due this Friday, April 10, 2020. We strongly urge members to complete this important cost survey which will provide aggregate information to assist NYSHFA in advocating for additional reimbursement on your behalf. The survey link is found in NYSHFA Priority Alert ...

Nursing Home COVID-19 Preparedness and Response Fiscal Survey

Carl J. Pucci in Finance & Reimbursement

Earlier today, the survey notification below was emailed to members: The Department of Health (DOH) has requested associations to assist the Department in collecting information about the financial impact on nursing homes of preparing and responding to the pandemic. The link below accesses the Nursing Home COVID-19 Preparedness and Response Fiscal Survey ...

AHCA: COVID-19 Update #31 - CMS Releases Recommendations to Nursing Homes

Carl J. Pucci and Jackie Pappalardi in Clinical & Quality, Finance & Reimbursement

In This COVID-19 Update:

  • CMS Releases Additional Recommendations to Nursing Homes
  • FAQs - Alignment of Isolation Waivers, MDS, and Payment Policies 
  • WPS Posts Updated Accelerated Payment Request Form

CMS Call with Nursing Homes Today

Stephen B Hanse in Clinical & Quality, Finance & Reimbursement

CMS is hosting a conference call today Wednesday, April 1st at 4:30 pm for a COVID-19 Call with Nursing Homes (see dial-in information below). CMS leadership will provide updates on the agency’s latest guidance and there will be audience Q&A. The call will be recorded if you are unable to join ...

AHCA Medicare Accelerated and Advance Payments FAQs

Stephen Hanse and Carl Pucci in Finance & Reimbursement

The attached Medicare Accelerated and Advance Payment for Part A & B services FAQs were developed by AHCA to supplement the recent CMS Fact Sheet. These FAQs are based on preliminary feedback from CMS to member submitted questions. CMS will be releasing its own version in the coming days, incorporating additional questions posed by members ...

UPDATED Medicaid Update Special Edition: Coverage and Reimbursement for COVID-19 Services

Stephen Hanse and Carl Pucci in Finance & Reimbursement

Attached please find a Medicaid Update Special Edition, issued on March 27 by the New York State Department of Health, featuring an updated New York State Medicaid Coverage and Reimbursement Policy for Services Related to Coronavirus Disease 2019 (COVID-19).  This guidance is an amended version of the original, sent March 10, 2020 ...

AHCA: COVID-19 Update #22 - Third Stimulus Package Signed Into Law

Stephen B Hanse in Clinical & Quality, Finance & Reimbursement

In This COVID-19 Update: 

  • Third Stimulus Package Signed into Law
  • VA Update 
  • Issues with Postal Carriers and Mail Delivery 

DOH: Updated COVID-19 Medicaid Update Special Edition: Comprehensive Telehealth Guidance 3-23-2020

Carl J. Pucci in Clinical & Quality, Finance & Reimbursement

Attached please find an updated version of the Medicaid Update Special Edition - Comprehensive Guidance Regarding Use of Telehealth including Telephonic Services During the COVID-19 State of Emergency, which now includes clarifications for FQHC billing as well as billing for home care providers ...

AHCA: COVID-19 Update #12 - Act Now to Conserve PPE

Carl Pucci and Jackie Pappalardi in Clinical & Quality, Finance & Reimbursement

NEW CDC Guidance on Use of Masks, Gowns, and Eye Protection to Conserve Supplies - CDC issued today new guidance on the use of masks, gowns and face shields including suggestions on what to do if in crises shortages (which most all of you are in) and when your supplies are exhausted (see below for summary) ...

DOH Issues Minimum Wage Survey

Carl J. Pucci in Finance & Reimbursement

DOH has issued a DAL which includes required survey information related to the States Minimum Wage increase from January 1, 2020 through January 1, 2021. Note: NYC Region (as defined in the DAL) is not required to complete the survey as the statutory minimum wage of $15/hour has been reached. 

A separate notification for Assisted Living Providers is forthcoming from DOH. We will alert members accordingly.

Below is the notification sent to Nursing Home Providers: 

Dear Administrator: 

Please find the attached letter requesting information from your facility regarding the State’s Minimum Wage increase from January 1, 2020 through January 1, 2021. The Department is surveying health care providers to determine the financial impact of scheduled minimum wage increases over the coming years. 

Please complete the survey found at http://www.surveygizmo.com/s3/5242529/8a78dcdcc774  using employee wage data from April 1, 2019 through June 30, 2019 for your facility. Please include in the count of hours for all direct care workers for which your agency can produce a payroll record, including direct contracted staff. 

Surveys are due by COB Wednesday, October 16, 2019

If you have any questions regarding the Minimum Wage Survey, please send an email with the subject line Minimum Wage to nfrates@health.ny.gov.

NYSHFA/NYSCAL CONTACT:

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