Cash Receipts Assessment Program

November 29, 2004

Dear Administrator/Controller:

Re: Cash Receipts Assessment Program-5% Assessment-Effective April 1, 2004

Assessments due for current months obligations should also be made at this 5% rate. To ensure provider receipt of necessary Medicaid rate adjustments, which change the reimbursable Medicaid portion of this assessment from 2.5% to 5% for affected months of service, the due date of your November 2004 Cash Receipts Assessment reports and payments (including the aforementioned retroactive adjustments) will be moved from December 15, 2004, to December 22, 2004. We note that the Medicaid cycle payment to be released on December 15, 2004, will include the retroactive adjustment to your 2004 rate incorporating the 5% reimbursable assessment for dates of services rendered on and after April 1, 2004.

We should also note, that you will shortly be receiving a letter from the Department providing you details on our implementation of interim rate changes necessary to add a year in the calculation of the regional input price adjustment factor as authorized by Chapter 58 of the Laws of 2004. Such interim rate changes, which will be reconciled at a later date, will impact Medicaid rates of payment for the April 1, 2004, through December 31, 2004, period. This retroactive rate adjustment will be paid prior to the end of this calendar year.

To retroactively pay the additional 2.5% assessment for affected monthly obligations that were previously paid, please submit the additional amount due (total of April through October 2004 payments) with your November 2004 report and payment. Report the additional amount due on Line 9, Other Adjustments and identify the amounts on the enclosed Addendum. Please note that a full reconciliation of these prior payments is expected by the above referenced due date. If not fully made, the Addendum should accurately identify the month(s) for which such adjustments apply.

If an assessment payment had not been previously made for an affected prior month(s), an additional report and 5% payment for such delinquent month(s) should be filed by the above referenced due date in addition to the November report and payment. If applicable, interest and penalty will be billed to your facility for such delinquent payment(s) under separate cover.

Failure to timely file the November 2004 report and payment, including the retroactive additional 2.5% assessment for the period April 2004 through October 2004, will result in the initiation of recoupment procedures against future Medicaid payments. Such recoupment procedures will also include appropriate penalty and interest.

If you should have any questions concerning the foregoing, please contact Mr. Walter Susko at (518) 473-4653.

Sincerely,

Mark H. Van Guysling
Assistant Director
Division of Health Care Financing

Enclosures