The fiscal intermediary PMPM battle continues, with New York State Department of Health filing a notice of appeal, signaling that it will seek to appeal the decision of an Albany County Supreme Court Judge that had ruled – only several weeks ago – that the PMPM reimbursement methodology for FIs was improperly promulgated by the Department and, thus, void. In its notice of appeal, the State did not seek to expedite its appeal of the Court’s decision, meaning that it could be months before the case is actually reviewed and heard by the Appellate Division, Third Department. In addition, the State did not seek a stay of the Court’s decision, which means that, until the Appellate Division, Third Department, rules otherwise, the Court’s decision invalidating PMPM stays in effect. As the appeal is proceeding through the court system, the State could seek to re-issue the PMPM methodology through proper regulatory channels, or to amend New York law and how FIs are reimbursed through the upcoming legislative session. There is no indication yet whether the State will do so. However, given its options to effectuate a PMPM reimbursement system for FIs faster than through an appeal, it is surprising that the State has chosen to appeal the Court’s decision.