Long-Term Care Reimbursement AB 1629
The Long-Term Care 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).
Temporary Increased Reimbursement for COVID-19 to LTC Facilities
Update: August 26, 2020
Due to the Coronavirus disease (COVID-19) outbreak, a public health emergency 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 will temporarily provide an additional 10% reimbursement for LTC per diem rates. The Department received federal approval of State Plan Amendment (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 the Department. The temporary increased rates for each facility by NPI number can be found at the bottom of this webpage. Once the updated rates have been implemented in the system to pay prospectively, the Department will run a subsequent Erroneous Payment Correction, retroactive to dates of service on or after March 1, 2020. 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 public health emergency or national emergency, whichever occurs first, LTC reimbursements will revert back to their regular facility-specific levels. The Department 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 Wage Survey
Update: January 29, 2020
The Department of Health Care Services (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 is conducting the 2020 survey to collect wage data in order to develop the add-on amount for Rate Year (RY) 2020-21, and better understand the overall wage impacts to LTC facilities.
DHCS requests for LTC providers to complete the wage survey by using the link provided below. Please forward completed surveys to AB1629@dhcs.ca.gov (FS/PSA, DP/PSA, FS/NF-B, FSSA/NF-B) with the subject line “2020 Supplemental Wage Survey".
The deadline to submit completed surveys is May 10, 2020.
Corrected 2019-20 Quality and Accountability Supplemental Payment Program Annual Report available.
Update: October 19, 2020
As a result of a data collection error, the April 2020 award payments issued on April 13, 2020 contained some erroneous payments. The corrected payment list has been published and is available for viewing on the Quality and Accountability Supplemental Payment Program webpage. The Department will perform an Erroneous Payment Correction to issue net payments or overpayment withholds, as applicable, resulting from corrected awards. Overpayments will be recouped from a provider's weekly check write and will be withheld at no more than the rate of 50% of their check write payment until the overpayment is fully recouped. Retroactive payment adjustments will be made automatically by the fiscal intermediary.
Please send your questions regarding any topic on this webpage to: AB1629@dhcs.ca.gov
Quality and Accountability Payment Program
Job Title Descriptions
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