​​​​Long-Term Care Reimbursement AB 1629

The Long-Term Care (LTC) System Development Unit establishes the Medi-Cal reimbursement rates for Freestanding Skilled Nursing Facilities Level-B (FS/NF-B), Adult Freestanding Subacute Facilities Level-B (FSSA/NF-B), NF-Bs designated as Institutions for Mental Diseases (IMD), Distinct Part Pediatric Subacute (DP/PSA) and Freestanding Pediatric Subacute Facilities Level B (FS/PSA).  

Latest News

  • Rates Available for Freestanding and Distinct Part Pediatric Subacute Facilities - Temporary Increased COVID-19 Rate Year (RY) 2021-22 Rates

Revised Annual Reports for QASP Available

Update: July 20, 2021

The Department submitted State Plan Amendment (SPA) 20-0021 for federal approval of the Quality and Accountability Supplemental Payment (QASP) program period of August 1, 2020 through December 31, 2021. The QASP award payments are generally paid to eligible facilities by April 30th of the program year, contingent on federal approval. For the August 2020 – December 2021 program period, the awards will be divided by the following service periods:

  • August 1, 2020 through June 30, 2021,
  • July 1, 2021 through September 30, 2021, and
  • October 1, 2021 through December 31, 2021

The total pool of funds of $78 million for the August 2020 – December 2021 program period will be prorated over the three service periods listed above, with $50.5 million for the August 1, 2020 through June 30, 2021 service period and $13.75 million for each of the remaining two service periods.

Award payments for the service period of August 1, 2020 through June 30, 2021 were issued on April 19, 2021. These initial award payments for the service period of August 1, 2020 through June 30, 2021 required a revision and recalculation to include additional facilities determined to be eligible in accordance with AB 81 (Chapter 13, Statutes of 2020) and some data corrections for certain facilities. These revisions resulted in underpayments to some facilities and overpayments to other facilities. Any underpayment or overpayment from the initial award revisions will be offset in the award payments issued in July 2021.

The revised payment lists, including the net award payment amounts made in July 2021, are available on the QASP webpage. Any facility with a remaining overpayment following the July 2021 awards may be subject to a recoupment through the Erroneous Payment Correction process. These retroactive payment adjustments will be made automatically and no action is required by providers.     

Temporary Increased Reimbursement for COVID-19 to LTC Facilities

Update: June 24, 2021

Due to the Coronavirus disease (COVID-19) outbreak, a public health emergency (PHE) was declared for the United States on January 31, 2020, and a national emergency was declared under the Stafford Act on March 13, 2020. In response to the COVID-19 outbreak, the Department of Health Care Services (DHCS) will temporarily provide an additional 10% reimbursement for LTC per diem rates. DHCS received federal approval of SPA 20-0024, effective March 1, 2020, which authorizes temporary additional reimbursement for eligible LTC facilities during the emergency period related to the COVID-19 outbreak.

In order for providers to receive the additional reimbursement they should bill at the temporarily increased rates established by DHCS. The temporary increased rates for each facility by NPI number can be found at the bottom of this webpage. Retroactive payment adjustments to March 1, 2020 will be made automatically by the fiscal intermediary, so no additional action will be necessary on the providers' part. 

Upon expiration of the PHE or national emergency, whichever occurs first, LTC reimbursements will revert back to their regular facility-specific levels. DHCS will post an update on this webpage to inform providers of the expiration of the emergency period and the corresponding expiration of the additional reimbursement.

Additional Medi-Cal information and updates related to the COVID-19 outbreak may be found on the DHCS COVID-19 Response website.

2020 AB 1629 Public Health Emergency Survey

Update: September 9, 2021

DHCS conducted a 2020 PHE survey to measure the increased costs that LTC providers experienced due to the COVID-19 outbreak. This voluntary survey compares 4th quarter operation costs for Calendar Year (CY) 2019 and 2020.

DHCS requests the participation of the below list of facility types:

  • FS/PSA
  • DP/PSA
  • DP/NF-B
  • DPSA/NF-B
  • FS/NF-B
  • FSSA/NF-B

This survey can be completed using the below survey link. All completed surveys and inquiries related to the survey can be submitted to the AB1629@dhcs.ca.gov email address. Please include “2020 AB 1629 PHE Survey" in the subject line of your email.

The deadline to submit completed surveys was July 15, 2021

FYE 2020 Supplemental COVID Audits

Update: June 24, 2021

Pursuant to Assembly Bill (AB) 81 (Chapter 13, Statutes of 2020), the funds received by FS/NF-B and FSSA/NF-B skilled nursing facilities associated with the COVID-19 PHE may be subject to audit by DHCS.

In addition to the notice provided by AB 81, this is to provide notice that Welfare and Institutions Code section 14126.032 requires DHCS to audit FS/NF-B and FSSA/NF-B costs and revenues that are associated with the COVID-19 PHE to determine whether a facility has adequately used increased Medi-Cal payments associated with the COVID-19 PHE to support the delivery of patient care. DHCS may recoup any amounts of the increased Medi-Cal payments associated with the COVID-19 PHE that DHCS finds were not used for allowable costs.

2021 Wage​ Survey

Update: September 9, 2021

DHCS provides reimbursement to LTC providers by way of an add-on to the Medi-Cal reimbursement rate for the additional cost of the wage increases pursuant to Senate Bill 3 (Chapter 4, Statutes of 2016).  

DHCS conducted the 2021 survey to collect wage data for the period from April 1, 2020 through June 30, 2020 in order to develop the add-on amount for the Rate Year (RY) 2021-22 and CY 2022 rate periods, and better understand the overall wage impacts to LTC providers. 

DHCS requests the participation of the below list of facility types:

  • FS/PSA
  • DP/PSA
  • DP/NF-B
  • FS/NF-B
  • FSSA/NF-B

This survey can be completed using the below survey link. All completed surveys and inquiries related to the survey can be submitted to the AB1629@dhcs.ca.gov email address. Please include “2021 Supplemental Wage Survey" in the subject line of your email. 

The deadline to submit completed surveys was June 30, 2021.

Contact Us

Please send your questions regarding any topic on this webpage to: AB1629@dhcs.ca.gov

Helpful Links

Quality and Accountability Payment Program

​​​​​Job Title Descriptions

 

In order to comply with the Americans with Disabilities Act (ADA), all Excel spreadsheet documents for RY 2019-20 have been locked. To unlock a 2019-20 worksheet, go to the Review tab at the top of the page and click Unprotect Sheet.​

Last modified date: 9/9/2021 2:50 PM