Attention Section 67, Nursing Facility Maine Veterans Home Providers - Supplemental Payment Information

Dec 16, 2022

Per PL 2021, ch. 528, An Act To Clarify State Policy and Legislative Intent Regarding the Maine Veterans' Homes, To Require Notification of Closure of the Maine Veterans' Homes to the Legislature and To Fund Public Homes in Caribou and Machias in Order To Keep Them Open the Department of Health and Human Services has allocated a COVID-19 temporary payment adjustment to Maine Veterans Home nursing facilities that provide comprehensive care to MaineCare veterans to meet their unique needs. The Department made this payment as part of the December 15, 2022, payment cycle and was indicated as an “OTHER” payment on the Summary page of the paper remittance advice (RA) and as an invoice number beginning with “MVSP” on the 835.  

This payment was calculated using uniform cost reports filed by the facilities, under the following methodology:

• The difference between the MaineCare payments and actual allowed MaineCare costs as reported on the 2021 cost reports for all eligible nursing facility services delivered by these facilities;
• The temporary payment adjustment across all eligible facilities shall not exceed the lesser of $2,442,200, or the difference as calculated under Step 1;
• Each facility’s annual payment adjustment shall be proportionate to its overall share of the amount calculated under Step 1 and limited to the aggregate amount across all facilities available under Step 2; and
• For each facility, if the amount calculated under Step 1 is greater than or equal to zero, the facility is not eligible for the temporary adjustment.

The payment is subject to the year-end uniform desk review audit and will be adjusted not to exceed the actual allowable costs of providing services to eligible residents.

The Department intends to seek and anticipates Centers for Medicare & Medicaid Services (CMS) approval for these payments.

Please contact your Provider Relations Specialist with questions.