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Hello Providers,
We are wanting to let you know that our attempts to distribute the enhanced federal match has hit a temporary barrier that requires us to make an adjustment to our initial plans. As we mentioned late last week, we have adjusted the base daily nursing facility rates by $29, so as to distribute the enhanced federal match that Washington is receiving on nursing facility services. We had hoped to make this rate change retroactive to February 1st, so as to allocate money to providers more quickly than if we just started the rate increase April 1st.
Unfortunately, we are still working with CMS to confirm how far our retroactive rate change can be applied. There are concerns that we may only be able to go back to March 1st. As soon as we get final confirmation with CMS we will make the appropriate adjustments to the rates and past claims. However, this does cause more immediate concerns that we want you to be aware:
- We have submitted mass adjustments for claims from March 1, 2020 forward with the additional $29 added to the rate.
- Depending on the final decision from CMS, we may still be able to extend the mass adjustment back to February 1st. Alternatively, we may need to reset rates higher to fully utilize the additional funding from March 1st onward.
- Although you all have the ability to adjust your historical claims back to February first, if CMS does not allow us to go back to February, we will have to correct your February claims for you. This could result in showing an over payment if you added the $29 to your rate and we are only authorized to pay your January 1, 2020 rate without the enhanced federal match.
As we are working through this, please bill for your January 1 rate plus $29. If you need to check what this rate is, they are posted at https://www.dshs.wa.gov/altsa/management-services-division/nursing-facility-rates-and-reports.
We are doing our best to work as quickly as possible to get as much of the federal funding available to us, out to you in this time of crisis. I apologize for the confusion and hope that we can fix this with minimal administrative burden on you and your facilities.
Peter Graham, Chief, Office of Rates Management
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