GIS 14 MA/03: Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2014

To: Local District Commissioners, Medicaid Directors

From: Judith Arnold, Director - Division of Health Reform and Health Insurance Exchange Integration

Subject: Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2014

Effective Date: January 1, 2014

Contact Person: Local District Support Unit - Upstate (518) 474-8887, New York City (212) 417-4500

The purpose of this General Information System (GIS) message is to inform local departments of social services of the year 2014 Medicaid regional rates which must be used to determine a transfer penalty period for coverage of nursing facility services. This is in accordance with 96 ADM-8, "OBRA '93 Provisions on Transfers and Trusts" and 06 OMM/ADM-5, "Deficit Reduction Act of 2005 - Long-Term Care Medicaid Eligibility Changes." These rates are based on average private pay nursing home costs in each of the seven regions in the State.

Central $8,645

  • Broome
  • Cayuga
  • Chenango
  • Cortland
  • Herkimer
  • Jefferson
  • Lewis
  • Madison
  • Oneida
  • Onondaga
  • Oswego
  • St. Lawrence
  • Tioga
  • Tompkins

Northeastern $9,212

  • Albany
  • Clinton
  • Columbia
  • Delaware
  • Essex
  • Franklin
  • Fulton
  • Greene
  • Hamilton
  • Montgomery
  • Otsego
  • Rensselaer
  • Saratoga
  • Schenectady
  • Schoharie
  • Warren
  • Washington

Western $8,971

  • Allegany
  • Cattaraugus
  • Chauatauqua
  • Erie
  • Genesee
  • Niagara
  • Orleans
  • Wyoming

Northern Metropolitan $11,135

  • Dutchess
  • Orange
  • Putnam
  • Rockland
  • Sullivan
  • Ulster
  • Westchester

New York City $11,423

  • Bronx
  • Kings (Brooklyn)
  • New York (Manhattan)
  • Queens
  • Richmond (Staten Island)

Long Island $12,112

  • Nassau
  • Suffolk

Rochester $10,073

  • Chemung
  • Livingston
  • Monroe
  • Ontario
  • Schuyler
  • Seneca
  • Steuben
  • Wayne
  • Yates

Reminder: Districts must use the rate for the region in which the facility is located.