Nursing Home and Residential Care FY 2023 Rate Letters are Available

• By: Angela Westhoff
• On: 10/06/2022 10:06:11
• In: Legislative/Government Affairs

The Department has posted Rate Letters for State Fiscal Year 2023 for Nursing Facilities (NFs) and Residential Care Facilities (RCFs, PNMI Appendix C) to the Health PAS Online Portal, and the rates have been loaded into MIHMS. Details about the timing of these rates were announced in a prior bulletin on August 31, 2022. 
 
The rates are retroactive to July 1, 2022, and result from the following changes:
 

1. NFs – (1) rebasing based on FY2021 cost reports, (2) application of 3.38% COLA (equal to the Consumer Price Index (CPI) required by statute and regulation), (3) inclusion of a new facility-specific add-on, where necessary, to comply with Section AAAA-5 of the biennial budget, 2021 P.L. Ch. 398, to enable providers to cover labor costs for essential support workers of at least 125% of the minimum wage, and (4) application of expanded eligibility criteria for High MaineCare Utilization Payments pursuant to 2022 Resolve, Ch. 171, To Amend MaineCare Reimbursement Provisions Governing Supplemental Payments to Nursing Facilities with High MaineCare Use.

 

2. RCFs – (1) application of 3.38% COLA (equal to the CPI required by statute and regulation), (2) inclusion of a new facility-specific add-on, where necessary, to comply with Section AAAA-5 of the biennial budget, 2021 P.L. Ch. 398, to enable providers to cover labor costs for essential support workers of at least 125% of the minimum wage, and (3) addition of High MaineCare Utilization Payments pursuant to 2022 P.L. Ch. 635.

 
The Department is seeking approval for these changes from the Centers for Medicare & Medicaid Services (CMS) and plans to undertake rulemaking. 

For submitted claims with service dates on or after July 1, 2022, providers can create adjustments to make the appropriate changes to the current rates.

Please see the Background on AAAA Ad-On Calculations document for an explanation of how the AAAA add-ons were calculated.
 
For questions, please contact Bruce Cosgrove, Provider Relations Specialist, by phone at (207) 624-6927 or by email at: bruce.cosgrove@maine.gov.
 
Staff contact: awesthoff@mehca.org