Indiana Medicaid Rate Update

The Indiana Office of Medicaid Policy and Planning (OMPP) has started issuing July 1, 2014 rate letters via its contractor Myers & Stauffer.  The rate component medians have been released and can be found by clicking here.  M&S is due to release the other LTC Information System reports on the 7/1/14 Rate Effective Date in the next week or so.  This includes information on the second year of facility performance in the Value Based Purchasing add-on (i.e. the Total Quality Score add-on).  IHCA is also hearing early rumblings that some facilities with Special Care Units (SCU) that have received 7/1/14 rate letters are seeing SCU add-ons in excess of what they expected.   IHCA urges facilities to double check their submitted cost report information against their rate letter, and eventually the M&S SCU calculation file that will be posted on the M&S LTC website this month.

In other Indiana Medicaid rate news, IHCA is expecting a decision from OMPP concerning the transition to RUGs IV this month.   There has been months and months of debate on whether such a transition should be to the 48 or 64 grouper, with IHCA and its members advocating for the 48 grouper.  IHCA has continued meeting with agency officials and most recently proposed a cost-neutral solution to the agency to that any cost to the State for transitioning to a 48-grouper system would be absorbed by redistributing gains and losses more equitably.  Beyond this issue are the issues of maintaining the SCU add-on, which two years ago was floated to be eliminated in order to in-part pay for the costs of moving to a 48-grouper, and whether or not to re-group Medicaid therapy residents at the end of therapy based on the reference MDS assessment already on file.  IHCA has argued against elimination of the SCU add-on and has advocated for a common sense approach to the end of therapy re-grouper, which at this point is not to do it since it costs the State money to do and derives no policy objective.

To learn more on these issues, contact Zach Cattell at 317-616-9001 or zcattell@ihca.org or particulate in our monthly Payment/Reimbursement Committee conference calls (contact Zach for this as well).