Warshaw Burstein LLP | Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2023
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Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2023

2023 Medicaid regional nursing home rates which must be used when calculating a transfer of assets penalty period for coverage of nursing facility services. This is in accordance with 96 ADM-8, “OBRA ’93 Provisions on Transfers and Trusts” and 06 OMM/ADM -5, “Deficit Reduction Act of 2005 – Long-Term Care Medicaid Eligibility Changes”. These rates are based on average private pay nursing home costs in each of the seven regions in the State.

Districts must use the regional rate in effect as of the date of application or the date request for an increase in coverage for the region in which the facility is located. The 2023 regional rates for calculating Medicaid penalty periods are found in GIS 22 MA/12, which is dated 12/05/2022. They are:

CENTRAL: $11,726
Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga and Tompkins.

Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, and Washington.

WESTERN: $12,130
Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, and Wyoming.

Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, and Westchester.

NEW YORK CITY: $14,142
Bronx, Kings (Brooklyn), New York (Manhattan), Queens and Richmond (Staten Island).

LONG ISLAND: $14,136
Nassau and Suffolk.

ROCHESTER: $13,421
Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne, and Yates.