The Nursing Home section calculates reimbursement rates for nursing home Medicaid providers based on cost data. Rate setting for nursing homes are completed once a year effective September 1, 2015. This section is also responsible for processing rate changes based on audit adjustments, interim rate calculations, and all other retroactive rate adjustments.Audit Services is responsible for the collection and review of nursing home cost reports based on Medicaid and cost reporting requirements. Facilities are selected for examination based on information contained in individual cost reports. The result of an examination is used to determine over/under payments made by Medicaid and are used to process necessary rate changes.
The Nursing Home section calculates reimbursement rates for nursing home Medicaid providers based on cost data.
During the 2016 Legislative Session, the Agency was required to contract with an independent consultant to develop a plan to convert Medicaid payments for nursing home services from a cost based reimbursement methodology to a prospective payment system.