Providers in New York are “pulling out all the stops to defeat” a proposed change to the way the state calculates reimbursement rates for long-term care facilities. The proposal could cost operators $246 million in funding. 

The state’s Department of Health is seeking to retroactively change the methodology used to calculate case-mix index adjustments, which sets Medicaid reimbursement rates for skilled nursing facilities. 

The agency filed the request to change the rate calculation method with the Centers for Medicare & Medicaid Services earlier this year. 

Providers are doing everything they can to ensure the proposal is defeated, LeadingAge New York Executive Vice President Dan Heim said. 

“It’s a big problem,” Heim told McKnight’s. “We’re trying to pull out all the stops and defeat this cut.”

Heim added that providers are “in a holding pattern at this point and a “cut like this will only make matters worse and put more facilities into financial straits.”

He said the state has yet to share the financial impact the policy change could have on facilities. Advocates, however, have estimated that the policy change will cost providers $246 million. 

The policy change would be retroactively effective as of July 1, 2019 if approved, Heim said. The organization is now encouraging their members to “calculate the (potential) impacts to their own facilities and communicate that information to their state lawmakers.”

Advocates have also asked the governor to forgo the cut and requested that CMS reject the states proposed change in methodology. 

Stephen Hanse, president and CEO of the New York State Health Facilities Association/New York State Center for Assisted Living, said the state already has an existing Medicaid shortfall of about $65 per patient per day and any changes would “absolutely result in (some) nursing homes closing.” 

“We’re working with all affected individuals, partners and organized labor to educate the public on how harmful these cuts would be,” Hanse told McKnight’s. 

“The state shouldn’t balance the budget on the backs of New York’s most vulnerable population and the men and women who care for that population,” he added.