Department of Health

Controlling Changes to Medicaid Provider Payment Rates

The hospitals, clinics, nursing homes and other such institutions that participate in New York State's Medicaid program are paid on the basis of reimbursement rates. Since the reimbursement rates are based on the operating expenses of the institutions, the rates are adjusted in response to changes in the operating expenses. We examined the procedures used by the Department of Health to ensure that the reimbursement rates are kept accurate. We found that a number of improvements are needed. For example, adequate action is not always taken to ensure that the rates are accurately updated when operating expenses change.

For a complete copy of Report 97-S-45 click here.
For a copy of the associated follow-up report click here.
For a copy of the 90-day response click here.