Dear Chief Executive Officer: GME Regional Covered Lives Assessment Rates

January 7, 2022

Dear Chief Executive Officer:

The enclosed schedule provides updated 2022 Regional Covered Lives Assessment (CLA) rates for the 2022 Calendar Year (CY) and includes the 2022 alternative inpatient surcharges. For reporting purposes, these amounts will be reflected in the 2022 service year portion of the Payor Report of Covered Lives Assessment and the Hospital Report of Patient Services Revenues for Inpatient Services.

Pursuant to sections 2807-s and 2807-t of Public Health Law, Covered Lives rates have been adjusted for 2022 based on:

  • Finalized CY 2022 Covered Lives Collections;
  • Finalized CY 2022 Covered Lives Enrollment;
  • Regional allocations; and,
  • Any prior period adjustments.

Please note that legislation has been signed at the end of December 2021 which will increase the CLA by $40 million for purposes dedicated to Early Intervention services. This increase is not reflected in these rates. Additional implementation detail will be provided.

This notice has been sent to you because your organization is an electing payor under the New York State’s HCRA Pools, paying and reporting directly to the Health Care Reform Act (HCRA) Public Goods Pool. If you use a third party administrator (TPA), we suggest that you contact your TPA directly concerning any questions you may have regarding this notice. Others having questions regarding these rates should contact a HCRA representative at webpools@hcrapools.org or (315)-671-3800.

Sincerely,

Michael Spitz
Bureau Director
Division of Finance and Rate Setting
Office of Health Insurance Programs

Enclosure