Medicaid activity updates Summer 2017


Medicaid Reimbursement Rates

All providers should have received their FY quarter 1 Medicaid Reimbursement rates. In addition to the new rates the Quality Assessment per day amount increased to $25.49 ($7.03 for the five facilities providing the most Medicaid days of services).  The new reporting forms are available on the Department of Health web site.  As you may be aware the Department of Health and Mental Hygiene has changed its name to The Department of Health, along with the name change all its web pages have been updated, so any bookmarks you may have set up are no longer valid. The main page is now

MDS Validation Audits

At the most recent Homing Home liaison meeting Telligen provided an update on the status of the MDS Validation Audit results to date.

  • By the end of July, they will have 135 facilities completed
  • 22 have triggered expand audits
  • 11 of those expanded audits triggered penalty audits. 
    • They did find that facilities in the early test had a higher error rate, and since education was provided the error rate has improved.
    • Changes:
      • Facilities with a 20% or lower error rate do not trigger an expanded audit
      • Facilities with an error rate of 40% or higher, skip the expanded audit and go directly to a penalty audit. (Penalties do not go into effect in the first year if these reviews.)
      • When filing your Plan of Correction, if required, you must complete a POC template which will be provided to your notification letter.  Both must be returned to