February 24, 2021
We have known for some time that OMH was working to move the OMH Outpatient Clinic Program out of the (federal) ‘Clinic’ Option and into to the (federal) ‘Rehabilitation or ‘Rehab’ option for some time.
As the DOH Notice (below) suggests, this would allow the availability and reimbursement of what we traditionally refer to as of ‘off-site’ (clinic) services, and reimbursement for services provided by certified peers. This move would also align OMH Outpatient Clinic Services with OASAS Outpatient Clinic Services (OASAS Outpatient Clinic already under ‘Rehab’ option).
See the NYS DOH Notice (below) regarding this proposed amendment to the state’s Medicaid State Plan (SPA).
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Date: Wed, Feb 24, 2021 at 9:57 AM
Subject: 2/24/21 NYSDOH Public Notice: Medicaid SPA re: Establishing Outpatient MH Services under the Rehabilitative Option
PUBLIC NOTICE
Department of Health
Pursuant to 42 CFR Section 447.205, the Department of Health
hereby gives public notice of the following:
The Department of Health proposes to amend the Title XIX
(Medicaid) State Plan for non-institutional services to comply with
enacted statutory provisions. The following changes are proposed:
Non-Institutional Services
Effective on or after February 24, 2021, the Department of Health will establish outpatient mental health services under the Medicaid State Plan rehabilitative option, including services currently authorized under the Medicaid State Plan clinic option. This will allow Medicaid to reimburse outpatient mental health services when provided in a site-based clinic, community setting or in the individual’s place of residence when permitted under State practice laws.
Rehabilitative outpatient mental health services will also include peer support services provided by certified peers.
The estimated annual net aggregate increase in gross Medicaid expenditures attributable to this initiative contained in the budget for State Fiscal Year 2020/2021 is $1.1 million and $4.2 million for State Fiscal Year 2021/2022.
The public is invited to review and comment on this proposed State Plan Amendment, a copy of which will be available for public review on the Department’s website at http://www.health.ny.gov/regulations/ state_plans/status. Individuals without Internet access may view the State Plan Amendments at any local (county) social services district.
For the New York City district, copies will be available at the following places:
New York County
250 Church Street
New York, New York 10018
Queens County, Queens Center
3220 Northern Boulevard
Long Island City, New York 11101
Kings County, Fulton Center
114 Willoughby Street
Brooklyn, New York 11201
Bronx County, Tremont Center
1916 Monterey Avenue
Bronx, New York 10457
Richmond County, Richmond Center
95 Central Avenue, St. George
Staten Island, New York 10301
For further information and to review and comment, please contact:
Department of Health, Division of Finance and Rate Setting, 99
Washington Ave., One Commerce Plaza, Suite 1432, Albany, NY
12210, spa_inquiries@health.ny.gov