July 1, 2015, Medicaid Rate Estimates Available

In our most recent edition of News Bites, we reported that the Department of Medicaid (ODM) is planning to finalize Medicaid SNF rates by mid June. We also said that we could not provide rate estimates, as we usually do, because ODM had not furnished the necessary case mix score data. That situation has changed, as shortly after we distributed News Bites, we received the case mix scores from ODM.

We now have estimated each center’s July 1, 2015, rate.

There are certain caveats:

• We are assuming each center achieves the full $16.44 quality incentive payment because the facility specific quality points for this year are not out yet.
  
  
• If your center is newly opened or experienced a CHOP, we have not prepared estimates because there are different rules for the rates based on the timing of the event. For CHOPs since March 31, 2015, we may have rate estimates, but they will not be accurate. Please see this ODM table for guidance on how rates are set for new and CHOP facilities, depending on the timing.
  
  
• If there are any errors in the case mix data we received from the state, the resulting rate estimates will be incorrect as well.