November 12, 2024
Thanks to so many of you for participating in last week’s weekly NYS Council Member Support and Public Policy meeting. I have two follow-up items for you:
1) Linked here please find the document our government relations consultant Marcy Savage used to brief NYS Council members re: the main elements of a revised OMIG Audit Reform bill that is streamlined, reflective of pushback from state leaders but that addresses what we believe to be several critical issues facing Medicaid providers beginning with our members.
2) As you know the NYS Council has been persistent in our pursuit of a response from OASAS and OMH regarding our numerous queries as to the applicability of Part O – a new section of state law that was enacted with the April 2024 state budget. Today I received confirmation that the state agencies (OASAS and OMH) agree that the specific provisions in 18-C apply to ALL healthcare providers including OASAS and OMH providers. But note that the provision requiring hospitals and health care providers to obtain a separate patient consent for treatment and payment “is on hold until further guidance is released” following outreach and questions from stakeholders (including the NYS Council). All other changes are effective October 20, 2024.
Here’s what I received last week from OMH that I described during our call last Thursday. I couldn’t share it word for word until OMH and OASAS got on the same page. OMH and OASAS now agree on the following:
In October DOH sent a guidance letter regarding the Part O changes to hospitals. The letter and an accompanying article can be found on the Nixon Peabody Website at https://www.nixonpeabody.com/-/media/files/alerts/2024/10/dear_hospital_chief_executive_officer_2024.pdf. Per the DOH guidance, sections 1, 2, and 3 of Part O apply to all hospitals in New York licensed by the Department of Health (DOH), but do not apply to any OMH licensed facilities. Section 4 requiring health care providers to collect separate consents for treatment and payment and section 5 prohibiting health care providers from (1) completing an application for medical financial products on behalf of a patient, and (2) requiring a patient put a credit card on file prior to providing emergency or medically necessary medical services to such patient apply to OMH and OASAS licensed providers since these provisions apply to all patients. DOH has put implementation of section 4 on hold until further guidance is issued.
NOTE: We have one outstanding question remaining as to whether providers with two licenses such as Article 28/31 or Article 28/32 must comply with ALL of the Part O changes (as described in the Hospital CEO letter) or just those sections that we have now established MH and SUD providers must comply with.
Stand by for more.
NEW CONSUMER PROTECTIONS, EFFECTIVE 10/20/24
The following is a summary of changes to (NYS) Public Health Law (§ 18C) and New York General
Business Law (§ 349-G and 519-A), that will go into effect on 10/20/24.
All patients receiving direct health care services, regardless of income level, eligibility for financial assistance, or the
type of provider from which the patient receives direct health care services, are covered by this law.
1) Separating consent to treat / consent to pay
The Department of Health has received outreach and questions from a variety of
stakeholders about the meaning of this provision. While the Department considers these
questions, the implementation of this provision is on hold until further guidance is
released.
2) Medical Financial Product Applications
a. Medical financial products are medical credit cards or third-party medical
installment loans.
i. A medical credit card is a credit card issued under an open-end or closed-
end plan offered specifically for the payment of health care services,
products, or devices provided to a person.b. It is prohibited for any hospital, health care provider, or employee/agent of a
hospital or health care provider to complete any portion of an application for
medical financial products for the patient, or otherwise arrange for or establish an
application that is not completely filled out by the patient. Providers may answer
patient’s questions and provide assistance if requested, so long as the
application is completed wholly by the patient.
3) Credit card pre-authorization
a. No hospital or health care provider shall require credit card pre-authorization or
require the patient to have a credit card on file prior to rendering emergency or
necessary medical services.
b. Health care providers may ask patients to voluntarily choose to have a credit
card on file but may not require patients to do so.
4) Credit card risk notification (ON HOLD)
a. Each time a credit card is used to pay for services, patients must be notified of
the risks of paying for medical services with a credit card; including:
i. Medical bills paid by credit card are no longer considered medical debt.
ii. By paying with a credit card, patients are forgoing federal and state
protections around medical debt.
iii. Protections that patients must acknowledge forgoing include:
1. Prohibitions against wage garnishment and property liens
2. Prohibition against reporting medical debt to credit bureaus
3. Limitations on interest rates
iv. Patients must affirmatively acknowledge forgoing these protections by paying with a credit card.
If you have questions or concerns please share them with us at: lauri@nyscouncil.org or call me at 518 461-8200 at your convenience.