IHCA
The Indiana Office of Medicaid Policy and Planning (OMPP) accepted the proposal made by IHCA, HOPE, and LeadingAge Indiana concerning a transition to RUVs IV. Effective July 1, 2016 Indiana Medicaid nursing facility rates will be calculated using the 48 grouper under RUGs IV. OMPP had been pressing for use of the 66 grouper. The 48 grouper that will be used will spend approximately $6.9M more than the current RUGs III 34 grouper. In order to cover that cost unspent dollars from the Quality Assessment Fee will be used. Approximately $5.8M dollars, which becomes $17.2M once leveraged with federal match, are unspent QAF.
OMPP has accepted this proposal with one caveat. The use of the 48 grouper will be for at least 1 year, and potentially more. OMPP will not commit to using the 48 grouper beyond 1 year (July 1, 2016 to June 30, 2017) until additional discussions and progress is made on the 5-8 year long term care plan occurs. That plan, reported on last month, is focused on rebalancing OMPP’s long term supports and services spend from institutional care to home and community based services.
Additional details from OMPP concerning the RUGs IV 48 grouper transition are expected in the coming weeks and IHCA will report those to members as they become available.
If you have any questions, please contact Zach Cattell at zcattell@ihca.org or 317-616-9001
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