Nursing Home Medicaid Rates Update

Nursing Home Medicaid Rates Update

The Office of Rates Management, Aging and Long-Term Support Administration is running the July 1, 2020 Medicaid rates this week.  You should be receiving your Rate Computation Worksheet shortly.

Rates are being rebased using the 2018 costs as reported on the cost report.

The inflation factor on the Direct Care and Indirect Care rate components is 1.91%.  This is based on the May CPI-U All Components Bureau of Labor and Statistics inflation.  The inflation factor has been applied to the median calculations for both of these components.

The Quality Enhancement add-on has been slightly reduced due to the redistribution.  Each tier in the add-on has been reduced by approximately 4%.  The new tiers are $10.47, $7.85, $5.24, and $2.62.

The $29 COVID-19 add-on from the enhanced FMAP is being discontinued for the time being.  DSHS has indicated that the add-on from the enhanced FMAP is likely to be reinstated, but at a lower rate than the $29 as the state intends to retain a portion of the FMAP as savings.  Although this add-on will not, in all likelihood, be in place when the July 1, 2020 rates are issued, DSHS intends to pay the add-on retroactively once the new add-on amount is known.  As soon as DSHS has determined the amount of the add-on, we will notify facilities.

Overall, excluding any COVID-19 add-on, rates have generally increased compared to the published 6/1/2020 rates.  To see what your estimated rates are, along with a comparison to your current 6/1/2020 rate minus the $29 COVID-19 add-on, please click here  If your facility is not on the list, please email David Carter at dcarter@leadingagewa.org so he can send your estimated rate.

Even with the rebasing to 2018 costs and exclusive of any higher costs related to the pandemic, Medicaid rates for nursing homes are still significantly lagging behind the costs to provide care.  We continue to advocate not only to stop any potential cuts or reductions, but to close the gap between the cost of providing care to many of our most vulnerable citizens and the Medicaid rates paid.

 

Questions?

Contact:


David Carter
| Director, Health Care Finance & Policy

C 360.888.5702