MedicaidAdministrativeLow impact
Fiscal Year 2023 Nursing Facility Pay-for-Performance Scores
Maryland Medicaid·MD · Geriatrics, Palliative Care·Provider Transmittal
Effective date
Nov 13, 2023
We identified it
Jun 20, 2026
Summary
Maryland's fiscal year 2023 nursing facility pay-for-performance program distributes approximately $14.2 million in quality incentive payments to high-performing facilities based on five quality measures. Facilities representing the top 40% of eligible days of care receive P4P payments ($5.84-$11.67 per Medicaid patient day), while improving facilities not in the top 40% qualify for pay-for-improvement payments ($1.68-$3.36 per Medicaid patient day). This is an informational transmittal notifying providers of their individual performance scores and award eligibility with a 30-day review period.
Action Required
By December 13, 2023: Nursing facility administrators and accounting staff should review the enclosed performance score letter to determine P4P or P4I eligibility. If any concerns exist regarding the scoring or data used, submit written notification to the Department of Health and Mental Hygiene, Division of Long Term Care Services (contact: Jane Sacco at jane.sacco@maryland.gov or 410-767-6771). Note that no supplemental data can be submitted to change results. Eligible facilities should ensure billing systems recognize the awarded incentive payment amounts per Medicaid patient day for revenue reconciliation and budget forecasting purposes. This is informational only and does not require changes to current billing or coding practices.