March 13, 2024
Remember: We are still peeling back the layers of the one-house budget bills. The information below (and what we’ve shared to this point) is subject to change.
HEALTH HOME The Senate one-house bill includes a full restoration of the Health Home ‘cost savings’ proposed by Governor Hochul in her executive budget. The Senate also includes Health Home Care Management in the proposed 3.2% COLA.
OASAS The Senate and Assembly both rejected an apparent (and much discussed) proposed reduction to the OASAS budget of $11.4M. Senate rejects the reduction and adds back $11.5M; Assembly rejects the reduction and adds back $11.4M.
OMIG AUDIT REFORM
The Senate one-house bill included OMIG Audit Reform language that is directly from our OMIG Audit Reform legislation. This is exactly what we wanted to see happen.
The Assembly one-house proposal does not include any specific language, nor does it knock out the additional $100M in revenue from increased OMIG Audit recoupments. However, it does state the following:
The Assembly Majority is committed to ensuring that community-based providers maintain their ability to provide high quality, patient-centered care to underserved communities across the State. To facilitate this goal, the Assembly Majority recognizes the need to reform the Office’s auditing practices and re-examining the use of extrapolation in instances where administrative errors are found in provider records rather than fraud and abuse. Human errors should be corrected but should not result in multi-million dollar recoupments by OMIG for high quality services that have already been rendered.
Commercial Rate Mandate
Next, here is a summary of each of the Commercial Rate Mandate proposals in the one-house bills:
Senate HMH Art. VII, Part AASenate accepts the Governor’s Executive Budget proposal language. Applies to in-network services.
Assembly HMH Art. VII, Part AA
Assembly modifies the Executive budget proposal to state that reimbursement for covered outpatient treatments shall be at rates negotiated between the insurer and the participating provider, provided that such rates are not less than the annual rates that would be paid for such treatments under Medicaid. The annual rates that would be paid for covered outpatient treatments shall be set annually no later than April 1st of each year for the reimbursement of such treatments provided during the subsequent calendar year. No further adjustments to such rates shall be made for each calendar year. Applies to in-network services.
RESOURCES
Finally, the Senate one-house bills dropped late Monday night, followed by the Assembly one-house bills that dropped yesterday afternoon. We are still scouring all of the bills. In the meantime we sent a partial list of Senate one-house outcomes yesterday morning, and we sent information regarding Assembly outcomes yesterday afternoon.
For a closer look at Assembly one-house proposals, use the document (attached) and the links (below):
Assembly Appropriation Bills:
- State Operations (A8800-B)
- Legislature and Judiciary (A8801)
- Debt Service (A8802)
- Aid to Localities (A8803-B)
- Capital Projects (A8804-B)
Assembly Article VII Bills:
- Public Protection and General Government (PPGG) (A8805-B)
- Education, Labor and Family Assistance (ELFA) (A8806-B)
- Health and Mental Hygiene (HMH) (A8807-B)
- Transportation, Economic Development and Environmental Conservation (TED) (A8808-B)
- Revenue (REV) (A8809-A)