Situation Report | April 12, 2021
The state Department of Health (DOH) has issued minimum wage adjustments for downstate Certified Home Health Agency (CHHA) Episodic Payment System (EPS) rates.
The retrospective adjustments are for January 1, 2018 through December 31, 2020 via an additional hourly amount uniform percentage add-on.
DOH made the announcement, dated March 2021, on its Long Term Care website under ‘CHHA Episodic Rates’ and then the 2018-2021 tab. (The Excel link to the actual rates near this announcement does not appear to be working. HCA has notified DOH and is awaiting a response and a fix.)
DOH has also stated that these rates will be posted to the Health Commerce System (HCS) but the rates do not appear to have been posted there yet.
NYC
The CHHA EPS minimum wage rate adjustments for providers operating in the five boroughs of New York City (NYC) have been increased by 9.92 percent in Calendar Year (CY) 2018 and 8.17 percent in CY 2019 to reflect the state-mandated minimum wage increases in NYC.
Long Island and Westchester
The CHHA EPS minimum wage rate adjustments for providers operating in Nassau, Suffolk and Westchester counties have been increased by 5.54 percent in CY 2018, 4.8 percent in CY 2019, and 4.55 percent in CY 2020 to reflect the state-mandated minimum wage increases in those counties.
The retrospective lump-sum payments were made in Medicaid Cycle 2273, check release date March 31, 2021. HCA encourages our CHHA members in the applicable regions to notify your appropriate staff about this payment.
HCA has long advocated for this retrospective adjustment, stressing that the adjustments are required by statute and noting that DOH has previously made such adjustments for downstate CHHAs’ CY 2017 EPS rates.
Other regions
DOH, however, did not make any such adjustments for providers in the rest of state, which has a different schedule of minimum wage increases. HCA urges DOH to make EPS minimum wage rate adjustments for CHHAs operating in the rest of state going forward.
We also note that these minimum wage updates are separate from CHHA EPS rebasing, which is also required by statute and has likewise been stalled at DOH. We continue to call on DOH to fulfill its obligation and appropriately update all applicable EPS, fee-for-service, and minimum wage Medicaid rates, which also serve as updates to Medicare and Medicaid managed care benchmarks for home care.
HCA has e-mailed the Department with multiple inquiries, especially as it relates to the current CHHA EPS rates in CY 2021 as well as the rates going forward, not only downstate but for CHHAs operating in the rest of the state as well. HCA will notify the membership as additional information becomes available.
CHHAs that have specific questions related to these retrospective Medicaid rate adjustments should contact DOH at Bltcr-ch@health.ny.gov.