Now Posted: Care Center Rate Notices

Posted on November 28, 2018 by Jeff Bostic

The fourth set of annual rates to be calculated using the new Value-Based Reimbursement (VBR) system will take effect on Jan. 1, 2019. The rates are now posted to the DHS Nursing Facility Provider Portal.

These rates were calculated based on costs reported on the Sept. 30, 2017 year-end cost report.

This increase in Medicaid rates will require the same level of increase for private pay residents in your setting, so communicating effectively about these increases with residents and families over the next couple of months will be important.

Now that the rate notices have been posted, members should provide a notice to their private pay residents that includes the exact amount to be charged starting Jan. 1. 

As in past years, the initial rate notice for many care centers will not reflect the audit adjustments to their 2017 cost report. However, the rate on that notice is the final set of MA rates effective Jan. 1 until a new notice is issued after the audit is final. Therefore, providers should plan to charge that rate to private pay residents starting Jan. 1. If the rates are subsequently reduced due to audit adjustments, the MA payments will be adjusted back to Jan. 1 but private pay charges do not need to be adjusted retroactively.

Contact Jeff Bostic if you have any questions regarding the new rates or the rate notice process.