ADVOCACY REQUEST — URGENT!

February 1, 2024

ACTION ALERT

Please Take Action Today to Support SFY 2025 Executive Budget Proposal to Require Commercial Insurers to Pay MH & SUD / Addiction Providers at a Minimum, at Medicaid Rates


PLEASE MAKE 2 CALLS TODAY IN SUPPORT!


We are so pleased to see that Governor Hochul has included this critical proposal in her SFY 2025 Executive Budget to finally bring some parity to commercial rates for behavioral healthcare services with what is paid by Medicaid for the same services.

We are also pleased to share that stand alone legislation has been introduced to address this issue by Senate Insurance Chair Breslin and Assembly Mental Health Chair Gunther (S.8466/A.8839) which also demonstrates legislative support.

For too long, commercial insurers have gotten away with paying on average 50% of what Medicaid pays for the same, essential services for the individuals we serve.  This must end this year and we need your help.

Please Make the Following 2 Calls Today to your State Senator and Assembly Member to urge their support for ensuring the inclusion of Part AA of the Health/Mental Hygiene Article VII Bill in their “one-house” budget bills and the final State Budget.  Please use the talking points provided (below) since the ask for each is slightly different due to a “sign on” letter Chair Gunther is circulating to her Assembly colleagues to demonstrate support.  Thank You!!

1) Call Your State Senator (switchboard number 518-455-2800):Introduce yourself as a constituent from their district and say you are calling to request the Senator’s support for an Executive Budget proposal to put an end to commercial insurers underpaying for mental health and substance use disorder care by requiring the plans to pay on par with Medicaid rates for the same services.  Tell them this is Part AA of the Health/Mental Hygiene Article VII Budget Bill and ask for their help to Ensure the Inclusion of this proposal in the Senate One House Budget and the Final State Budget.

2) Call Your State Assemblymember (switchboard number 518-455-4100): Introduce yourself from their district and say you are calling to request the Assemblymember’s support for an Executive Budget proposal to put an end to commercial insurers underpaying for mental health and substance use disorder care by requiring the plans to pay on par with Medicaid rates for the same services.  Tell them this is Part AA of the Health/Mental Hygiene Article VII Budget Bill and ask them to Sign On to the Letter to the Speaking Circulated 1/31 by Mental Health Chair Gunthercalling for Inclusion of this proposal in the Assembly One House Budget and the Final State Budget. The deadline is February 12th and Assemblymembers can sign on by letting Lena in Gunther’s office now at: dethoml@nyassembly.gov

Talking Points 

  • For too long New Yorkers with commercial insurance benefits have faced disparate access to care due to a longstanding problem in which mental health and substance use disorder providers are reimbursed (on average) just 50% of the state mandated reimbursement rate paid for services for Medicaid beneficiaries. 

           and,

  • As a result, community-based mental health and addiction community-based agencies often cannot afford to serve many New Yorkers with commercial insurance.  
  • This situation has resulted in what we often refer to as state sanctioned discrimination in that the state has always had the ability to change this but, to this point, has failed to do so – until now.
  •  The Governor’s executive budget proposal includes a provision in the Article VII bill, HMH Part AA that would remedy the disparity in access to care faced by New Yorkers with commercial insurance by mandating commercial insurance plans to reimburse community-based providers (at a minimum) at the same amount as the state mandated Medicaid rate. 
  • Every New Yorker should have equal access to mental health and addiction prevention, treatment, recovery, and harm reduction services regardless of the insurance card in their pocket, or when they have no insurance.  
  • At a moment in time when there are long waiting lists for services through New York’s public mental hygiene system, every proposal that to seeks ensure on demand access to care at the correct level of care, should be enacted  to address the ongoing overdose epidemic and increasing rates of suicide.