The NYS Council, along with our partners from a broad range of associations, coalitions and groups representing stakeholders across the state, is spearheading a new campaign designed to compel NYS leaders to remove OASAS and OMH outpatient, rehabilitation and residential services from the state’s Medicaid managed care program. At the moment we are laser focused on our request to Governor Hochul to include this critical policy reform in her January 2026 executive budget. In doing so, the Governor would be continuing her track record of policy reforms that increase access to care while returning scarce resources to our systems of care.

Please join the fight here!

As a result of the NYS Council advocacy, Fidelis has POSTPONED to January 1, 2026, its proposed OMH Group and Family Therapy Concurrent Authorization Process. This includes Concurrent Review: Group (CPT 90853) and Family Therapy (CPT 90847). All treatment for Substance Use Disorder has been EXCLUDED from the Fidelis Concurrent Review requirements.

The information is available on the Fidelis website here.

The Department of Budget (DOB) has now approved the 2.6% Targeted Inflationary Increase (TII) enacted in the State Fiscal Year (SFY) 2025-26 budget, effective April 1, 2025. The NYS Council has strongly supported annual TIIs for providers.

All Medicaid Managed Care Plans, HARPs, HIV SNPs, and MAP Plans (collectively referred to as “MMCPs”) are required to pay claims based on the effective date of the rate changes. As a result, MMCPs must complete necessary system edits to ensure payable claims with dates of service on or after April 1, 2025, for applicable programs are reimbursed accurately and timely. Additionally, MMCPs are required to conduct
retrospective reconciliation to adjust payments for clean claims as necessary. MMCPs must complete these activities as soon as possible, but no later December 24, 2025.

The NYS COUNCIL has been selected by City & State magazine as one of New York’s Top 25 Trade Associations.  A special print issue of City & State magazine is on its way to the mailboxes of C&S subscribers across the region while the online list of winners is available here.

THANK YOU to every NYS Council agency for your incredible dedication and focus on what matters most! Your peers, state government officials, elected leaders, and other key decision makers are recognizing your game-changing achievements today, while millions of New Yorkers continue to benefit from your advocacy and laser-like focus on timely access to care for those who need your services and support.