As we previously reported, DMAS posted the Medicaid rates for the state fiscal year (SFY) that begins July 1, 2021. The agency has now posted the related Medicaid Memo on Nursing Facility and Specialized Care Rate Updates Effective July 1, 2021. The rates include an inflation adjustment of 5.9 percent.

Other nursing facility rate updates are:

• adjustment factor increases;
• operating rate increases for special populations;
• modify capital rate for hospital-based nursing facilities that build a replacement facility in a new location;
• sunsetting COVID-19 add-on payment; and
• Metropolitan Statistical Area (MSA) changes.

Specialized care rates effective July 1, 2021 are inflated by 5.9 percent in accordance with the budget approved by the General Assembly earlier this year.

VHCA-VCAL had anticipated a substantial increase in the rate based on a review of the wage survey data. The application of the inflation and rebasing fix results in a year-to-year increase in Medicaid revenue (aggregate) of 4.3 percent after including the reduction from $20 to $15. Based on the Medicaid days from the rebasing, this is estimated to equate to $54.2 million in added revenue year-to-year.

The rates are posted on the DMAS nursing facility rate setting webpage. If you would like a company summary of the rates or have any questions, please contact Steve Ford.