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Volume 20.04

The New York Department of Health is launching a new Web-Based Tool for Home Care cost reports, set to be published mid to late March 2020, that providers will be required to complete using fiscal year 2019 cost and utilization data that will be used to set 2021 Medicaid reimbursement rates.  The new report format will replace the existing New York Personal Care cost reports and Certified Home Health Agency (“CHHA”) cost reports filed through the Health Commerce System (“HCS”).  All reports are due on or before June 30, 2020.  Ms. Christy Conaway of The Health Group, LLC attended the introduction and training on the new reports and process yesterday.

Some of the changes include a consolidated report format, an expanded geographical data, expanded data collection, and elimination of the CPA certification of the cost report filing.

The new Web-Based Tool for cost reporting will be used for all Certified Home Health Agencies (“CHHA”), Licensed Home Care Services Agencies (“LHCSA”) and Fiscal Intermediaries (“FI”).  Multiple CHHA, LHCSA and FI entities can/will be reported on a single agency’s report.  An agency is defined as an organization that operates one or more CHHA, LHCSA and FI under a single tax ID.  An entity is defined as a CHHA, LHCSA and FI, and may be operated as part of a larger agency or may be free-standing.  For purposes of reporting multiple entities on a single agency report, operating certificate numbers will be used as the unique identifier for CHHAs and LHCSAs/FIs are required to be separated by county.  Additionally, cost report schedules required will be tailored based on the number and type of entities included in the report.

In past filings, many providers in New York City and surrounding burrows were not required to submit cost reports nor were providers that only received Medicaid Managed Care reimbursement.  Under the new reporting, providers in NYC and its burrows, as well as providers who are reimbursed through Medicaid Managed Care, are required to submit the new cost report in order to obtain “complete state” data for purposes of rate setting.  For those providers with Medicaid Managed Care contracts, the cost report could be used as a rate negotiating tool for future contract negotiations.  Also, CHHAs are now required to report episodic information on the cost report.

Finally, the NYDOH has contracted with KPMG to conduct audits of the Home Care cost report submissions; accordingly, the CPA certification of the cost reports is no longer required. However, the cost report must still be certified by a corporate executive (i.e. CEO or CFO).  If the agency has financial statements (audited, compiled or reviewed) prepared/certified by an outside CPA, the cost report needs completed on the same basis of accounting and reconciled to the issued financial statements.

If providers have not received an informational survey to complete or notifications of the training sessions, they need to contact CHHA-Rates@health.ny.gov or PersonalCare-Rates@health.ny.gov


If your agency uses an outside consultant for preparation of the Home Health Agency Cost Report, make certain that the consultant is aware of the changes effective for cost report periods beginning on or after July 1, 2019 and ending on or after June 30, 2020.   Most agencies are already into the cost reporting period for which the new report will apply.  Draft forms and instructions are available here.