April 28, 2023

As you know, in 2020 the NYS Council fought aggressively for the Executive to require the Department of Health to recoup overpayments made by the state to MCOs when they (MCOs) failed to meet expenditure targets that govern how much of the funds they receive from the state are to spent on actual care for Medicaid beneficiaries.  The result was return of $222M ($111M state share) to both OMH and OASAS for a two year period (with more funds coming in the budget that is currently in play) and regulatory changes that will prevent this failure to enforce contract provisions from happening again. In the past we have reviewed how OMH used the funds to significantly increase rates for numerous OMH programs and services including (but not limited to) the OMH Outpatient Clinic, PROS, ACT, etc.   On the OASAS side, the Office is using the funds as follows:

• 5% trend on every Medicaid-able OASAS service except hospital inpatient (effective Jan 1, ’23)
• off-site rate code enhancement for freestanding outpatient and OTP (effective Jan 1, ’23)
• Peer weight increase (effective Jan 1, ’23)
• Addiction Specific E&M APG weight increases (effective Jan 1, ’23)
• Part 820 Residential Rate Increases (effective March 1, ’23)

Specifically, OASAS Part 820 increases  (effective March 1 pending final approvals) look like this:

• Rehab Level= 4.5% increase across the state
• Stabilization Level= 15% increase across the state, w/ 5.6% more for downstate

Note:  I regularly check with OASAS leads to get a status update on the pending increases (above) and will do so again before the Webinar  for OASAS Residential Providers on 5/10 (see below and attached).  Perhaps there will be some good news during the Webinar re:  the rate increases.

From OASAS:

Dear Certified Residential Service Providers:

OASAS invites all Residential Service provider leadership to participate in this facilitated conversation to explore strategies for successful transition to Part 820 Elements of Care

Date: May 10th 2023.

Time:1Pm-2Pm

Join by phone+1-518-549-0500 US (English Menu)

Communications Department

NYS Office of Addiction Services and Supports (OASAS)