Gis Medicaid Rates

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GIS 17 MA/19

DIVISION: Office of Health Insurance Programs

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 Pserson:        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

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