As a general reminder, the Medicaid rates effective October 1, 2021 included two enhancements to the direct care, other direct care, and indirect care components of Resource Utilization Group (RUG) rates:

1. A cost of living adjustment of 2.2%
2. A minimum staffing add-on of 0.5%.

Providers must pass through 80% of these enhancements to direct care staff during the period October 1, 2021, through September 30, 2022. Providers will also be required to sign an attestation and submit detailed reporting to the Rhode Island Executive Office of Health and Human Services (EOHHS). The submission deadline has been extended from December 31, 2022, to March 31, 2023.

Additional information on eligibility can be found below:

• Eligible increases towards the 80% include increases to base wage rates and the related increase to payroll taxes.
• Eligible direct care staff includes registered nurses, licensed practical nurses, certified nursing assistants, certified medication technicians, licensed physical therapists, licensed occupational therapists, licensed speech-language pathologists, mental health workers who are also certified nurse assistants, physical therapist assistants, housekeeping staff, laundry staff, dietary staff, and other similar employees providing direct care services. Employees contracted through a vendor or staffing agency are excluded.

The reporting is subject to audit by EOHHS and providers should retain all payroll records used to compile the reporting.  Providers that cannot substantiate eligible use of the 80% will be subject to a clawback and a 25% penalty of the unspent or impermissibly used portion.

Further information, including the Sample Certification Form, can be found on the RI EOHHS website.

For more information, contact Michael E. Criscione at mcriscione@citrincooperman.com or Lauren A. Florio at lflorio@citrincooperman.com.