Provider Notice Issued 12/20/2019

Date:  December 20, 2019                                       
 
To:     Long Term Care Facilities - Nursing Facilities (NF), and Specialized Mental Health Rehabilitation Facilities (SMHRF)
 
Re:     Nursing Facility Rates Effective July 1, 2019
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This Notice informs Nursing Facility (NF) providers that the Department has received federal approval to implement the rate increases specified in Public Act 101-0010.  The rate increases are effective July 1, 2019 and incorporate two reimbursement methodology changes:
-        Updating the base fiscal year used to determine the Support component rate, which increases spending by $170 million annually, and
-        Adding a $4.55 per diem amount to the Nursing component rate to addressing facility staffing needs, which increases spending by $70 million annually.
Specialized Mental Health Rehabilitation Facilities (SMHRF) will also receive the Support component rate increase.
The updated rates for the July 1, 2019 and October 1, 2019 quarters have been entered into the State’s payment system.  The Department will systematically reprice claims that have already been paid at lower rates.  This adjustment process will take a few weeks to complete, and vouchers for these payments will be generated later in January.  All newly submitted claims will be priced using the updated rates.
The newly approved rates have already been shared with the Managed Care plans and should be in their payment systems.
Rates are posted to the Department’s webpage and can be viewed at the following link: Medicaid Reimbursement Long Term Care. 
If you have questions, contact the Bureau of Long Term Care toll free at 844-528-8444.
 
Doug Elwell
Medicaid Administrator 
 
 

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