Recently, the Division of Medicaid Services (DMS) within the Department of Health Services (DHS) held it’s first public Methods of Implementation meeting for SFY23 via Zoom.

The meeting was led by David Albino, Interim Section Chief for the Nursing Home Policy & Rate Setting Division of the Department of Health Services. You can find all meeting materials here.

Albino first introduced some new staff in the Division and also noted that there are currently some vacancies as well. Personnel from Myers & Stauffer were present as well and presented information from cost reports.

Albino stated that they are working internally to make small tweaks to the auditing and rate-setting process in order to ensure rates are set as close to the beginning of the new fiscal year on July 1 as possible. They did not share specifics of what those tweaks would entail.

Next, Albino shared that the Dapartment’s interpretation of the 2021-2023 Biennial Budget language will remain as it did last year, meaning that $20 million is required to be put into Direct Care – Nursing. The remaining funds have yet to be allocated and there will be open discussions about how that money will be spent. WHCA/WiCAL has maintained the opinion that the majority of the remaining funds should go into the Support Services cost center. Albino indicated there is an interest to look into transportation rates but no specific plans or dollar amounts were mentioned.

The hold harmless related to the transition to PDPM billing was addressed next. DMS is still awaiting finalized first quarter data, which is expected at the end of June, before making any decisions about the phase-out of this maximum $2 ppd loss. Albino will report on the data and future plans at the next Methods meeting. However, a representative from Myers & Stauffer shared a spreadsheet that will eventually be shared with providers showing their specific PDPM results and whether they can expect a retroactive payment from this hold harmless.

Albino opened the meeting up to feedback regarding suggestions for spending or policy changes. Both WHCA/WiCAL and LeadingAge Wisconsin have previously met and shared our respective priorities with DMS. Please see the WHCA/WiCAL SFY2023 priorities below:

• Do not remove the 50 bed incentive;
• Make a substantial dedication to the Support Services Cost Center which continues to be starved of funding each year.  Since Support Services is priced-based, all facilities would be treated equally and would have greater flexibility to spend the money where it is most needed;
• Take a broader interpretation of the $20 million dedication language for Direct Care (broader than just the Direct Care Nursing Cost Center);
• Retain the additional $6 million in state funds that DHS inserted into the budget to help facilities that were below the Direct Care Nursing screen;
• Recycle any surplus in the NF Medicaid budget on June 30^th rather than have this surplus default to the general fund; and
• Retain the $2 per patient per day hold harmless floor on PDPM meaning that the most that any facility could lose on any patient because of the transition from RUGS to PDPM is $2 per patient per day.

There will be two future meetings yet this summer but they have not been scheduled at this time. As soon as they are announced, WHCA/WiCAL will share those dates and times.