Two major converstions affecting reimbursement occurred this week. First, how the 61.5 million-dollar Medicaid add-on would be distributed and second, a preview of the FY24 rates, impact and payment limits.
Addressing the Medicaid add-on:
While we had envisioned a lump sum payment to each facility when we presented the request to the legislature, KDADS presented three options for distribution of funds.
Three options for distributing 61.5 million Medicaid Add-on dollars.
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This option would pay each facility a one-time lump sum payment based on the facility’s FY22 percentage of Medicaid occupancy. KDADS did some research and in order to do a directed, lump sum payment they would need to get CMS approval through completion and submission of a 438.6(c) Preprint document. This is a time consuming and administratively burdensome process which includes quality metrics. KDHE indicated we should expect it to take 6 plus months for CMS approval, if everything goes smoothly.
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Variable rate: based on percentage of FY22 Medicaid occupancy. Array of $2 to $25 per Medicaid resident per day going forward. You have to effectively “earn” your additional dollars. Start date is uncertain.
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Flat rate: based on FY24 Medicaid occupancy. Every facility would receive $19.58 per Medicaid resident per day again going forward. The start date could be as soon as July 1, 2023.
KDADS prefers the Flat rate option. They said, “If we act quickly, we could see these rates added into the 7/1/23 calculations and facilities will start to receive the add-on with their first claims submission in FY24.”
After carefully weighing the options, your KHCA board of directors selected to support the third option. The primary reason was a definitive start date. LeadingAge Kansas’s (LAK) board of directors also selected this option. KACE deferred to whatever decision KHCA and LAK agreed to.
The second major event was the preview of the FY24 (July 1, 2023) rates using a full rebase and inflation based on cost report years 2020, 2021 and 2022. The July 1, 2023 rates will also reflect the Medicaid add-on. The result (click the image to enlarge if needed):
