MDHHS Releases Notice on FY 22 Medicaid Rates and More (SNF)
MDHHS has issued L letter 21-70 providing updates regarding the FY 22 Medicaid rates, QAS payments and lump sum payments. Highlights of the letter are below by category to access the entire letter click HERE.
Medicaid Rates
The FY22 Medicaid rate methodology will need to be approved by CMS through a state plan amendment prior to releasing the rates. The updated rate setting methodology will be used to establish rates that will be effective October 1, 2021.
Until the change in FY22 rate setting methodology is approved, NFs will continue to be reimbursed according to FY21 rates. Once FY22 rates have been established, MDHHS will reimburse NFs based on the difference between the FY21 rates and the FY22 rates. This reimbursement will be retroactive, dating back to the effective date of October 1, 2021.
QAS Payments
Nursing facilities received an October QAS payment equal to the amount the facility received in September 2021. In November 2021, and until the SPA is approved, the QAS will be calculated with the FY21 rate and annualized days from 2020. Once the FY22 rates have been established, MDHHS will reimburse Nursing Facilities based on the QAS payments calculated for FY22. This reimbursement will be retroactive, dating back to the effective date of October 1, 2021.
Lump Sum Payment
Due to the financial impact that COVID-19 has had on nursing facilities, a lump sum payment will be made. This payment will be funded using Federal Relief Funds.
Class I & Class III facilities.
This Class I and Class III nursing facility lump sum payment shall be structured as a 1.5% increase to the Medicaid per-bed day variable cost reimbursement rate effective
October 1, 2021, and shall include the related quality assurance supplement. The department shall determine the quality assurance supplement by multiplying the new variable rate base effective October 1, 2021, by 21.76%. The 1.5% increase shall then be applied to the new variable cost reimbursement rate per day amount (including QAS) multiplied by the 2019 Medicaid days of care.
Class V.
The Ventilator Dependent Care Units (VDCU) will still receive a 2.5% increase to their FY22 interim rate, but will also receive a lump sum payment structured as no less than a 6.72% increase to the Medicaid VDCU rate effective October 1, 2020, multiplied by the 2019 Medicaid days of care.