135 Pinelawn Road
Suite 110 South
Melville, NY 11747

631-756-6006

GIS Medicaid Rates

WGIUPD
GIS 17 MA/19
GENERAL INFORMATION SYSTEM
DIVISION: Office of Health Insurance Programs

12/4/17


To: Local District Commissioners. Medicaid Directors
From: Judith Arnold, Director
Division of Eligibility and Marketplace Integration
SUBJECT: Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2018
EFFECTIVE DATE: January 1,2018
CONTACT PERSON: Local District Support Unit

The purpose of this General Information System (GIS) message is to inform local departments of social services of the year 2018 Medicaid regional nursing home rates which must be used when calculating a transfer of assets 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. Districts must use the regional rate in effect as of the date of application or the date of request for an increase in coverage for the region in which the facility is located.

  • Central
  • $9,722
  • Broome
  • Cayuga
  • Chenango
  • Cortland
  • Herkimer
  • Jefferson
  • Lewis
  • Madison
  • Oneida
  • Onondaga
  • Oswego
  • St. Lawrence
  • Tioga
  • Tompkins
  • Northern Metropolitan
  • $12,428
  • Dutchess
  • Orange
  • Putnam
  • Rockland
  • Sullivan
  • Ulster
  • Westchester
  • Northeastern
  • $10,719
  • Albany
  • Clinton
  • Columbia
  • Delaware
  • Essex
  • Franklin
  • Fulton
  • Greene
  • Hamilton
  • Montgomery
  • Otsego
  • Saratoga
  • Rensselaer
  • Schenectady
  • Schoharie
  • Warren
  • Washington
  • New York City
  • $12,319
  • Bronx
  • Kings (Brooklyn)
  • New York (Manhattan)
  • Queens
  • Richmond (Staten Island)
  • Long Island
  • $13,053
  • Nassau
  • Suffolk
  • Western
  • $10,239
  • Allegany
  • Cattaraugus
  • Chautauqua
  • Erie
  • Genesee
  • Niagara
  • Orleans
  • Wyoming
  • Rochester
  • $11,692
  • Chemung
  • Livingston
  • Monroe
  • Ontario
  • Schuyler
  • Seneca
  • Steuben
  • Wayne
  • Yates