NF and RCF July 1, 2022 Rate Letters Delayed Until October 3, 2022 

We had previously announced that SFY23 rate letters for providers in Section 67 and Section 97, Appendix C would be delayed until September 1, 2022 due to the effort required for providers to submit wage data for Department analysis necessary to implement section AAAA-5 of the biennial budget, 2021 P.L. Ch. 398, which requires that direct care rates for providers in Section 67 and Section 97, Appendix C enable providers to cover labor costs for essential support workers of at least 125% of the minimum wage. That delay was decided upon in collaboration with the Maine Health Care Association (MHCA). 
MHCA and the Department have opted to further delay rate letters until no later than October 3, 2022 (retroactive to 7/1/22), due to the submission of wage template data from a number of facilities that failed general reasonability tests the Department conducted (e.g. alignment of numbers with provider’s submitted cost reports, calculated wages that equaled at least minimum wage). This subsequent delay will allow facilities that had submitted the unusable data to submit corrected data. The Department has already notified facilities that submitted unusable data that they must submit new templates by this coming Friday, August 12. Facilities that did not receive a Department request to resubmit data do not need to take any further action: the Department has the data it needs from these facilities to calculate the rates per Part AAAA. 

In order to help mitigate potential fiscal impact of this further rate delay, the Department expedited release of the $25 million Long Term Care (LTC) supplemental payment to facilities, as announced last week in a MaineCare e-message and press release from the Governor, and has adopted broader guidelines for use of these payments and any unspent funds from the previous LTC supplemental payment. 

In order to mitigate the impact of this further rate delay on facility financial planning, the Department will send out the following information later this month: (1) 7/1/22 Nursing Facility rebased rates, excluding forthcoming Part AAAA adjustments, and (2) 7/1/22 Residential Care Facility (RCF, PNMI C) High MaineCare Utilization Payment amounts pursuant to Public Law 2022 Chap 635, that will be added on top of normal RCF rate adjustments (which, per general practice, (a) will include an additional year of inflation (3.38% the December 2021 CPI for nursing home services, as required by statute and regulation) and (b) will use facilities’ most recent case mix index).  

For questions regarding this message, please contact Grace Williams in MaineCare Rate Setting.

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