New York State Passes 2025 Budget: Impact on Your Health Care Facility

Over the weekend, New York State passed the budget for Fiscal Year 2025 which included numerous provisions regarding Medicaid, reimbursement, and even collections which will impact your health care facility.

Here are the highlights that affect Skilled Nursing Facilities and Assisted Living Programs:

1. $825 million in reimbursement increases for hospitals, nursing homes, and assisted living programs, in addition to the rate increases over the previous two budgets, as follows:

• Nursing Homes: increased by an aggregate of up to $285 Million
• Assisted Living Programs: increased by an aggregate of up to $15 Million
• Hospitals: increased by an aggregate of up to $525 Million

The increases can be in the form of increased Medicaid rates, lump sum payments, or state-directed payments through managed care. The increases are subject to federal financial participation.

2. The operating component of nursing home rates is frozen at last year’s rates while DOH develops a new methodology that complies with CMS Patient Driven Payment Model, reducing the capital cost component of nursing home rates by 10%.

3. $350 Million State-Share for Medicaid Rate increases, to include hospitals, nursing homes, and Assisted Living Providers (ALPs).

4. Collections/Debt Recovery

The 2025 budget includes legislation designed to protect low-income New Yorkers from medical debt lawsuits by banning hospitals from suing patients earning less than 400 percent of the Federal Poverty Level, or $120,000 for a family of four. The legislation also expands hospital financial assistance programs for low-income New Yorkers and limits the size of monthly payments and interest charged for medical debt recovery. It appears that this legislation applies only to “general hospitals” at this time.

Cona Elder Law’s experienced attorneys continue to monitor the most recent legislative developments and other important legal matters concerning the nursing home industry.  Contact us at 631.390.5000 or click here to learn more about how our firm can help your facility preserve your bottom line and ensure your ability to continue to provide quality services to your residents.