GIS 17 MA/019 - Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2018

To: Local District Commissioners, Medicaid Directors

From: Judith Arnold, Director, Division of Eligibility and Marketplace Integration

Subject: Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2018

Effective Date: January 1, 2018

Contact Person: Local District Support Unit: Upstate (518) 474-8887; NYC (212) 417-4500

The purpose of this General Information System (GIS) message is to inform local departments of social services of the year 2018 Medicaid regional nursing home rates which must be used when calculating a transfer of assets penalty period for coverage of nursing facility services. This is in accordance with 96 ADM-8, "OBRA '93 Provisions on Transfers and Trusts" and 06 OMM/ADM-5, "Deficit Reduction Act of 2005 – Long-Term Care Medicaid Eligibility Changes." These rates are based on average private pay nursing home costs in each of the seven regions in the State. Districts must use the regional rate in effect as of the date of application or the date of request for an increase in coverage for the region in which the facility is located.

Central $9,722
Broome Jefferson Oswego
Cayuga Lewis St. Lawrence
Chenango Madison Tioga
Cortland Onedia Tompkins
Herkimer Onondaga
Northern Metropolitan $12,428
Dutchess Orange Putnam
Rockland Sullivan Ulster
Westchester
Northeastern $10,719
Albany Fulton Saratoga
Clinton Greene Schenectady
Columbia Hamilton Schoharie
Delaware Montgomery Warren
Essex Otsego Washington
New York City $12,319
Bronx Kings (Brooklyn) New York (Manhattan)
Queens Richmond (Staten Island)
Long Island $13,053
Nassau Suffolk
Western $10,239
Allegany Cattaraugus Chautauqua
Erie Genesee Niagara
Orleans Wyoming
Rochester $11,692
Chemung Livingston Monroe
Ontario Schuyler Seneca
Steuben Wayne Yates