This program will provide Michigan skilled nursing facilities an overview of the changes in rate setting, initial and final settlements, and related limits as allowed by the State Plan Amendment 0013 and audit requirements. The rate setting methodology was changed for state fiscal years 2022 and 2023 to recognize the financial toll on providers through the pandemic. The rates will be based on the actual provider costs from their Medicaid cost reports for fiscal year 2022 and 2023. This rate methodology change flows through to the settlement for these years and directly impacts the amount of QAS paid based on these rates. The program will also present the latest information regarding the development of a new reimbursement system for skilled nursing services. MDHHS and HCAM along with other stakeholders have been meeting frequently to design this system. The program will also provide an overview of the MI Health Link transition to a HIDE SNP. Types of D-SNP's will be discussed, along with information regarding how the HIDE SNP transition will effect providers going forward.

Learner Objectives:

1. Describe the changes in Medicaid rate setting, settlement, audit and related variable cost and plant limits for SFY 22-24, along with upcoming SFY 25 changes.
2. Discuss the proposal to revise the current reimbursement methodology potentially effective October 1, 2024.
3. Discuss the MI Health Link program transition to a HIDE SNP and how this will effect providers in Michigan.