March 18, 2014 Department of Health Letters to Workers' Compensation Board
March 18, 2014
Mr. Robert E. Beloten
Chairman
New York State Worker& Compensation Board
20 Park Street
Albany, NY 12207
Dear Mr. Beloten:
The Office of Health Insurance Programs has calculated rates of reimbursement for the period January 1, 2014 through March 31, 2014 for acute per case inpatient rates and January 1, 2014 through December 31, 2014 for exempt hospitals, exempt units and detoxification inpatient rates. These rates have been calculated for services rendered to patients covered under the Workers' Compensation Law, the Volunteer Firefighters' Benefit Law, the Volunteer Ambulance Workers' Benefit, and the Comprehensive Motor Vehicle Insurance Reparations Act.
Pursuant to section 2807(4) of the Public Health Law, I hereby certify to you that the rates appearing on the enclosed schedules have been developed in accordance with section 2807-c of the Public Health Law, as amended by the Health Care Reform Act, and Part 86-1 of the Title 10 (Health) of the Codes, Rules and Regulations of the State of New York.
Sincerely,
Jason A. Helgerson
Medicaid Director
Office of Health Insurance Programs
March 18, 2014
Mr. Robert E. Beloten
Chairman
New York State Worker's Compensation Board
20 Park Street
Albany, New York 11207
Dear Mr. Beloten:
Enclosed please find the certification letter and schedules of hospital reimbursement rates for services rendered to patients covered under the Worker's Compensation Benefit Law, the Volunteer Ambulance Workers' Benefit Law and the Comprehensive Motor Vehicle Reparation Act. These rates are for the period January 1, 2014 through March 31, 2014 for acute per case inpatient rates and January 1, 2014 through December 31, 2014 for exempt hospitals, exempt units and detoxification inpatient rates. Rates of payment for these services for these payers is to be based upon rates determined for state governmental agencies (Medicaid) in accordance with Article 2807-c (6-1) of the Public Health Law.
The Division of Finance and Rate Setting is in the process of rebasing the hospital acute inpatient rates which was to be effective for discharges on or after January 1, 2014. On December 9, 2013, in consensus with the Hospital Associations, hospitals were notified of a delay of the rebasing of the 2014 acute rates. With this delay, the implementation of the 2014 APR-DRG Service Intensity Weights (SIWs) and 2014 v31 grouper were also delayed until the 2014 rebasing of acute rates is completed. The 2014 rebased rates, SIWs and grouper will be implemented prospectively and will NOT be retroactive to January 1, 2014. At this time, payments for discharges effective on or after January 1, 2014 will be processed utilizing the 2013 SIWs, 2013 v30 grouper and the rates that are supplied with this publication. The statewide base price used in the January 1, 2014 acute rate calculation is the April 1, 2013 base price.
The rates on the attached schedules are based upon those rates previously certified to you for the period January 1, 2013 through December 31, 2013 but also incorporate the following:
- Inclusion of a 2014 trend factor in the amount of 1.9% based upon the initial CPI as published in the Federal Register and as required by Section 10 of Article 2807-c of the Public Health Law
- Inclusion of 2014 budgeted capital as submitted by hospitals in place of the 2012 budgeted capital in accordance with Section 8 of Article 2807-c of the Public Health Law
Should you have any questions or require further information, please contact Janet Baggetta at 518-474-3020 or via email at HospFFSunit@health.state.ny.us.
Sincerely,
John E. Ulberg, Jr.
Medicaid Chief Financial Officer
Division of Finance and Rate Setting
Office of Health Insurance Programs
