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Department of Health’s Reduction of Medicaid Reimbursement to Nursing Homes Upheld

The Third Department, in a highly technical decision applying the legislature’s mathematical analyses and formulas for the determination of Medicaid reimbursement rates for two nursing homes, determined Supreme Court had erred in annulling the Department of Health’s reduction in reimbursement:

…[W]e agree that the Department was authorized by these laws to reduce both the initial and the final trend factor by one percentage point.  * * * Where, as here, “the statutory language is special or technical and does not consist of common words of clear import, courts will generally defer to the agency’s interpretative expertise unless that interpretation is unreasonable, irrational or contrary to the clear wording of the statute” … .  Additionally, as the law at issue is susceptible to different interpretations, the Department’s past practice is given great weight in determining the law’s meaning … .  Here, the record confirms that the Department has previously amended both the initial and the final CPI pursuant to legislative directives containing the phrase “trend factor projection” … .  We are therefore persuaded that the Department’s interpretation of this law is in accord with its historical practice … .  Moreover, we note that such an interpretation effectuates the Legislature’s intent to achieve cost savings in the Medicaid program… . Matter of Avenue Nursing Home and Rehabilitation Centre…, 516272, 3rd Dept 12-19-13

 

 

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