DAL-CHHA Medicaid Reimbursement Rates

  • Letter is also available in Portable Document Format

October 20, 2022

Dear Administrator:

This letter provides you with information regarding your Adult Day Health Care (ADHC) Medicaid reimbursement rates effective January 1, 2022 and April 1, 2022. These rates have been promulgated in accordance with Article §2808 2-c of the Public Health Law.

The initial rates are provided on the Health Commerce System (HCS) application (Healthcare Financial Data Gateway/NH Rate Sheets 4/2009-Forward/2022 ADHC January & April Rates), and can also be found on the DOH website.

These rates include the operating, capital, and non-capital components, as well as the components of the Miscellaneous Per Diem Adjustment. Below are the changes being captured within these rates:

  • Miscellaneous Components: The April 1, 2022 rates have been updated to include a 1% operating increase that was included in the SFY 23 Enacted Budget. Additionally, both the January 1 and April 1, 2022 rates include the 1.5% transformation fund add-on and the applicable 5% capital reduction enacted in the SFY 2020 Enacted Budget. The calculation of both add-ons and the capital reduction are posted outside of the rate sheets in an excel spreadsheet with the above link and on the HCS.
  • Capital Component: The 2022 ADHC rates utilize the 2021 capital component that is based upon your facility's 2019 certified cost report and reflects approved attestations received during the preview period. The 2019 cost reports were selected because the March 17, 2020 mandated suspension of services of ADHC facilities resulted in incomplete data for the 2020 cost reports due to the COVID-19 pandemic

The Department's regulations allow rate appeals to be filed within 120 days from the date of this letter. The deadline to file appeals pertaining to the January 1, 2022 and April 1, 2022 ADHC rates is midnight, February 15, 2023. The payment will be made in cycle 2358, check release date November 16, 2022. If you have questions regarding the rates, please send an email with “2022 ADHC Rate Inquiry” in the subject line to nfrates@health.ny.gov and a member of our team will respond to your inquiry.

Sincerely,

Laura Rosenthal, Director
Bureau of Nursing Home and LTC Rate Setting
Division of Finance and Rate Setting
Office of Health Insurance Program