PNMI Appendix C Facilities: Update to Rates for State Fiscal Years 2020 and 2021

Updates to Rates for PNMI Appendix C Facilities are forthcoming. After considering feedback from providers and the impact of the COVID-19 Public Health Emergency, DHHS has decided to revise some of those inflationary factors back to the original factors, resulting in a partial upward adjustment to rates for both years.

There are two categories of changes being made:

  • A projected 5.7% inflation amount was used for the period 1/1/19 – 6/30/20 in the original rate letters. This inflation adjustment was intended to be “trued up” to equal actual inflation, if necessary, at the end of the year. The December 2020 communication and reissuance of the SFY21 rate letter reflected this true-up to actual 4.0% inflation. Due to the impact of COVID-19, the Department has decided to leave the higher 5.7% inflation in place for FY20 and FY21 rate letters.

  • The other inflation adjustments referenced in the December 2020 e-message were necessary in order to correct historical errors the Department discovered. These downward adjustments will remain in place, as the Department has an obligation to correct all errors and would be at audit risk if it did not do so.

Five revised rate letters (covering the periods listed below) will be posted at the portal no later than the end of July; another message will be sent at that point to inform you that the letters are available.

  1. 7/1/19 – 12/31/19
  2. 1/1/20 – 6/30/20
  3. 3/1/20 – 5/31/20 (temporary COVID-related ECA rates)
  4. 7/1/20 – 12/31/20
  5. 1/1/21 – 6/30/21

Facilities may choose to rebill any services that are within the one year window from the date of service; any unadjusted claims will be handled at settlement.

Rate letters for the current period 7/1/21 – 12/31/21 will be posted at the portal no later than early August. Please note that the inflation factor for the period 1/1/19 – 6/30/20 will revert to 4.0% (from 5.7%) in these forthcoming FY22 rate letters and rate letters for all future periods.

Staff contact: