Cash Receipts Assessment Program
November 30, 2004
Dear Administrator:
Enclosed please find rates and supporting schedules that detail adjustments made to the cash receipts assessment rates. The cash receipts assessment rate beginning April 1, 2002 was intended to reimburse each facility for its respective expenditures incurred pertaining to the cash receipts assessment program. Such amounts needed to be prospectively determined and reimbursed in the appropriate years to insure that facilities did not experience negative cash flow. This rate was based on estimated data.
Non-Delinquent Facilities
The Department now has actual facility specific expenditures for the April 1, 2002 through December 31, 2003 period for all facilities that are current in the assessment payments. If your facility was current in the cash receipts assessment payments, rate adjustments were made to reconcile your actual payments with the payments made by Medicaid for the period. The revised rates enclosed herein were calculated utilizing these actual expenditures divided by the respective 2002 and 2003 calendar year patient days as reported. The total patient days exclude Medicare days for rates effective October 1, 2002 and subsequent. In addition, a rate adjustment has been made effective April 1, 2004 to increase the reimbursable assessment from 2.5% to 5%. This calculation is detailed below.
Delinquent Facilities
If your facility has been identified as being delinquent in its cash receipts payment obligations for this period, a reconciliation was not done. For delinquent facilities, the cash receipts assessment rate was revised effective October 1, 2002 to exclude the Medicare revenue and Medicare days as reported in the 2000 cost report. This rate was further revised effective April 1, 2003 to reduce the cash receipts assessment percentage from 6% to 5%. In addition, a rate adjustment has been made, effective April 1, 2004 to increase the reimbursable assessment from 2.5% to 5%. This calculation is detailed below.
Calculation of the Assessment Rate Effective April 1, 2004
Chapter 58 of the Laws of 2004, Part C, Section 6 amended the assessment percentage from 2.5% to 5% of the residential health care facility's gross receipts received from all patient services excluding Medicare and other operating income, on a cash basis, for hospital or health-related services, including adult day services effective April 1, 2004.
The per diem rate for your facility was calculated as follows:
1. 2004 gross revenue was estimated by taking patient service revenues and other operating revenue reported in the 2002 cost report filed for each facility.
- For RHCF-4 filers, revenues reported in Part IV, Exhibits G and E and in Schedules 7 and 8C of the 2002 RHCF-4 were used. The specific class codes/line numbers (CCLN) are:
| Exhibit G | 20/99 | RHCF Total Inpatient |
| 764/99 | Specialty Pediatric Total Inpatient | |
| 864/99 | Head Injury Total Inpatient | |
| 964/99 | AIDS Total Inpatient | |
| 1064/99 | Long Term Ventilator Total Inpatient | |
| 1164/99 | Respite Care Total Inpatient | |
| 1264/99 | Behavioral Intervention Total Inpatient | |
| 28/99 | Adult Day Health Care (1) Total Outpatient | |
| 1628/99 | Adult Day Health Care (2) Total Outpatient | |
| 1728/99 | Adult Day Health Care (3) Total Outpatient | |
| 1729/99 | Adult Day Health Care (4) Total Outpatient | |
| 1730/99 | Adult Day Health Care (5) Total Outpatient | |
| Exhibit E | 11/36 | Total Other Operating Revenues |
| Less: | 11/30 | Investment Income Restricted |
| Less: | 11/28 | Contributions |
| Schedule 7 | ||
| Less: | 463/13 | RHCF Medicare |
| 763/13 | Pediatric Medicare | |
| 863/13 | Traumatic Brain Injury Medicare | |
| 963/13 | AIDS Medicare | |
| 1063/13 | Ventilator Dependent Medicare | |
| 1163/13 | Respite Medicare | |
| 1263/13 | Behavioral Intervention Medicare | |
| Schedule 8C | ||
| Less | 291/35 | Health Retention & Recruitment |
- For RHCF-2 filers, patient services revenues reported on Exhibit 46 of the 2002 Institutional Cost Report (ICR) were used.
2. The adjusted 2002 gross revenues were trended to 2004. The 2004 health retention & recruitment amounts for non-publics, the 2004 nursing home quality assurance grant awards for non-publics (if applicable) and the 2004 dementia grants (if applicable) were added to the trended 2004 estimated revenues. The 5% assessment was applied to the 2004 estimated revenues. This assessment amount was divided by estimated 2004 total patient days (excluding Medicare days) to calculate the reimbursable assessment per diem, which is enclosed herein. The 2004 estimated total patient days are based on total patient days reported on CCLN 620/17 less Medicare days reported on CCLN 620/13 in Part I of the 2002 RHCF cost report.
If your facility did not submit a 2002 cost report, submitted only a Part I of the 2002 cost report or opened subsequent to 2002, the assessment is based on 5% of the facility's current 2004 Medicaid rate. If your facility has multiple levels of care, the 5% assessment is applied to a blended rate weighted by total days.
If appealing the cash receipts assessment rates, the appeal must be based upon technical errors
in the calculation and/or implementation of the cash receipts assessment
rate.Such appeal must be filed with this office and be postmarked no later than 30 days from receipt of this
letter. If you are revising reported revenue data for your cost
report, you must refile your cost report electronically through HPN and submit
the appropriate certifications based on the new DCN number. When submitting an appeal, please be advised that the New York State Commissioner of
Health may consider only those applications for revisions of certified rates
which are set forth in sections 86-2.13 and 86-2.14 of the Commissioner's
Administrative Rules and Regulations. Issues raised in a request for appeal that do not meet the criteria of
an acceptable appeal under 86-2.13 or 86-2.14 but rather pertain to the
methodology used to promulgate Medicaid rates will be rejected. The Medicaid rate methodology is based on
the provisions of Subpart 86-2 and objections to regulatory or statutory provisions are not issues that can
be resolved through the administrative rate appeal process. If you have any questions relating to the calculation of your cash receipts
assessment rate, contact Henry Cassidy at (518) 473-9213. Sincerely, Mark H. Van Guysling Enclosure(s)Appeals
Assistant Director
Division of Health Care Financing
