Assemblymember Simon Introduces Our BH MMC
April 23, 2025
1) As you know, the NYS Council has been leading an effort to compel state leaders to release us from the quagmire we are mired in as the result of the state’s decision over a decade ago to ‘carve in’ most outpatient mental health and substance use disorder services into the state’s Medicaid managed care program. You also know that we drafted bill language several years ago and have been shopping it ever since.
Recently we requested and Assemblywoman JoAnn Simon (Chair, Assembly Mental Hygiene Committee) agreed to sponsor and champion our legislation (see below) in the Assembly, and we are currently awaiting a bill # for a ‘same as’ Senate bill that will be sponsored by Senate MH Chair Samra Brouk. Many thanks to both lawmakers for championing this important effort!
The delay in getting a new state budget has slowed movement on most policy matters that will be taken up during the remaining months of the legislative session. We have a great deal of work to do in a short period of time to ensure our bill gets the attention and votes it needs to get us out of this mess once and for all. Stand by for more on this.
2) Also (below the info about the MMC bill) we copied information regarding a newly introduced bill that would extend provisions relating to mental health practitioners getting diagnostic privileges to 6/24/27. We are reviewing the bill and will have more shortly.
3) See additional news and information below the Diagnostic Privilege information.
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A8055 Simon No Same as
Social Services Law
TITLE….Relates to outpatient mental health and substance use disorder services and Medicaid fee-for-service
| 04/22/25 | referred to health |
STATE OF NEW YORK
________________________________________________________________________
8055
2025-2026 Regular Sessions
IN ASSEMBLY
April 22, 2025
___________
Introduced by M. of A. SIMON -- read once and referred to the Committee
on Health
AN ACT to amend the social services law, in relation to returning outpa-
tient mental health and substance use disorder services to Medicaid
fee-for-service
The People of the State of New York, represented in Senate and Assem-
bly, do enact as follows:
1 Section 1. Subdivision 3 of section 364-j of the social services law,
2 is amended by adding three new paragraphs (d-4), (d-5) and (d-6) to read
3 as follows:
4 (d-4) Subject to federal approval, outpatient mental health services
5 as determined by the commissioner of the office of mental health,
6 provided to individuals with mental illness at facilities or in programs
7 licensed pursuant to article thirty-one of the mental hygiene law or
8 clinics serving individuals with mental illness licensed pursuant to
9 article thirty-one of the mental hygiene law, or dually licensed pursu-
10 ant to article twenty-eight of the public health law and article thir-
11 ty-one of the mental hygiene law shall be administered and managed under
12 fee-for-service in the medical assistance program.
13 (d-5) Subject to federal approval, outpatient substance use services
14 as determined by the commissioner of the office of addiction services
15 and supports, provided to individuals with substance use disorder at
16 facilities or in programs licensed pursuant to article thirty-two of the
17 mental hygiene law or clinics servicing individuals with substance use
18 disorders licensed pursuant to article thirty-two of the mental hygiene
19 law, or dually licensed pursuant to article twenty-eight of the public
20 health law and article thirty-two of the mental hygiene law shall be
21 administered and managed under fee-for-service in the medical assistance
22 program.
23 (d-6) Subject to federal approval, comprehensive Medicaid case manage-
24 ment services provided to individuals with mental illness or substance
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD11629-01-5
A. 8055 2
1 use disorder shall be administered and managed under fee-for-service in
2 the medical assistance program.
3 § 2. Section 365-m of the social services law is amended by adding a
4 new subdivision 6 to read as follows:
5 6. (a) Pursuant to appropriations within the office of mental health
6 and the office of addiction services and supports, the department of
7 health shall reinvest savings realized through the transition of outpa-
8 tient mental health and substance use disorder services pursuant to
9 paragraph (d) of subdivision three of section three hundred sixty-four-j
10 of this title from the managed care model to the Medicaid fee-for-ser-
11 vice system for the purpose of increasing investment in community based
12 behavioral health services, including residential services certified by
13 the office of addiction services and supports.
14 (b) The commissioner shall include information regarding the funds
15 available for reinvestment from the transition of outpatient behavioral
16 health services from managed care to fee-for-service on its website and
17 the funds shall be included in each year's annual budget itemization,
18 beginning April first, two thousand twenty-six.
19 § 3. This act shall take effect October 1, 2025; provided, however,
20 that the amendments to section 364-j of the social services law made by
21 section one of this act shall not affect the repeal of such section and
22 shall be deemed repealed therewith.
NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A8055 SPONSOR: Simon TITLE OF BILL: An act to amend the social services law, in relation to returning outpa- tient mental health and substance use disorder services to Medicaid fee-for-service PURPOSE OR GENERAL IDEA OF BILL: This legislation would return outpatient mental health and substance use disorder services to Medicaid Fee-For-Service (FFS) for reimbursement. SUMMARY OF SPECIFIC PROVISIONS: SECTION 1: Amends the social services law to require that outpatient mental health and substance use disorder services are reimbursed under FFS Medicaid, subject to federal approval. SECTION 2: Amends the social services law to require that the savings realized from the return of outpatient mental health and substance use disorder services back to FFS Medicaid are reinvested in community based behavioral health services overseen by the Office of Mental Health and the Office of Addiction Services and Supports. This section also requires that information regarding the funds available for reinvestment from the return of these services to FFS Medicaid be included on the State Department of Health's website and itemized in the annual state budget beginning April 1, 2026. SECTION 3: Establishes the effective date. JUSTIFICATION: The State began carving in behavioral health services into the state's Medicaid managed care program in 2015. This shift has been a failure with serious negative outcomes. Managed care means that middlemen (managed care plans) are paid to reimburse providers for Medicaid bene- fits for vulnerable New Yorkers with mental health and substance use disorder service needs. Many managed care plans have been found to violate state laws, regulations or contract provisions while New Yorkers wait to obtain care from a community-based provider that has to employ full-time staff who do nothing but deal with health plans and chase reimbursement from delinquent insurers. When plans fail to reimburse providers on time and in full, providers are unable to pay adequate wages to staff, increase the amount of care they provide to match demand, or manage ever increasing operating expenses associated with running these programs. New York State could save hundreds of millions of dollars per year by carving out outpatient mental health and substance use disorder services from the state's Medicaid managed care program where managed care plans are permitted to keep (at a minimum) 11% of the funds they are paid by the state for profit and 'administrative expenses' despite the fact that there is no value add associated with employing these companies. This savings from returning these services to FFS Medicaid should be properly directed to actual mental health and substance use disorder services for New Yorkers, not to health insurance plan administration and profits. It is urgent that New York State carve outpatient behav- ioral health service reimbursement out of Medicaid managed care as this legislation provides. PRIOR LEGISLATIVE HISTORY: New Bill FISCAL IMPLICATIONS: This legislation will save the state hundreds of millions of dollars by no longer paying managed care plans to reimburse for outpatient behav- ioral health services. EFFECTIVE DATE: This act shall take effect October 1, 2025.
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| A 8045 Bronson Same as S 7622 BROUK EducationTITLE….Extends certain provisions authorizing certain mental health practitioners to engage in diagnosis and the development of assessment-based treatment plans04/22/25referred to higher education | S7622 BROUK Same as A 8045 Bronson NOT ON FILE EducationTITLE….Extends certain provisions authorizing certain mental health practitioners to engage in diagnosis and the development of assessment-based treatment plans04/23/25REFERRED TO HIGHER EDUCATION |
STATE OF NEW YORK
________________________________________________________________________
8045
2025-2026 Regular Sessions
IN ASSEMBLY
April 22, 2025
___________
Introduced by M. of A. BRONSON -- read once and referred to the Commit-
tee on Higher Education
AN ACT to amend chapter 230 of the laws of 2022, amending the education
law relating to diagnostic privilege, in relation to extending the
effectiveness of certain provisions thereof
The People of the State of New York, represented in Senate and Assem-
bly, do enact as follows:
1 Section 1. Section 6 of chapter 230 of the laws of 2022, amending the
2 education law relating to diagnostic privilege, is amended to read as
3 follows:
4 § 6. This act shall take effect June 24, 2022; provided however, that
5 sections two and three of this act shall take effect June 24, 2024;
6 provided, further, that the provisions of section five of this act shall
7 expire and be deemed repealed June 24, [2025] 2027. Effective imme-
8 diately, the addition, amendment and/or repeal of any rule or regulation
9 necessary for the implementation of this act on its effective date are
10 authorized to be made and completed on or before such effective date.
11 § 2. This act shall take effect immediately.
NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A8045 SPONSOR: Bronson TITLE OF BILL: An act to amend chapter 230 of the laws of 2022, amending the education law relating to diagnostic privilege, in relation to extending the effectiveness of certain provisions thereof PURPOSE OR GENERAL IDEA OF BILL: Extends certain provisions authorizing certain mental health practition- ers to engage in diagnosis and the development of assessment-based treatment plans. SUMMARY OF PROVISIONS: Section 1. Extends the certain provisions authorizing certain mental health practitioners to engage in diagnosis and the development of assessment-based treatment plans. Section 2. Provides for the effective date. JUSTIFICATION: There are critical workforce shortages in the mental health professions across New York State, There is a need to ensure that programs and services providing addiction and mental health services to children; adults and communities have the appropriate staff to provide comprehen- sive services, including diagnosis. Licensed mental health counselors (LMHC), marriage and family therapists (LMFT), and psychoanalysts (LP) currently do not have the authority do diagnose. To increase the number of licensed mental health professionals authorized to diagnose, this bill would establish requirements for these professionals to obtain a diagnostic privilege. The requirements for the diagnostic privilege, intended to align with the requirements of a licensed clinical social worker, include: * filing an application with SED; * being licensed and registered in the state as a LMHC, LMFT, or LP; * verifying the completion of a 60-semester hour master's degree or higher, including 12 semester hours (or the equivalent) of clinical courses; and * having completed at least 2,000 hours of supervised, direct client. contact hours, unless the applicant can attest to having certain accept- able experience. In addition, this bill would allow, LMHCs, LMFTs and LPs currently work- ing in certain settings, as defined by SED in regulations, provided that such settings shall not include a private practice owned or operated by the applicant, to continue to diagnose through June 24, 2025. At such time, individuals will need to obtain a privilege from SED in order to diagnose. This provision ensures that our community substance abuse and mental health providers have adequate workforce to meet the current demand for care. PRIOR LEGISLATIVE HISTORY: New Bill. FISCAL IMPLICATIONS FOR STATE LOCAL GOVERNMENTS: To be determined. EFFECTIVE DATE: Immediately.
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Webinar on Guidance for the Community Mental Health Loan Repayment Program Round 6 – 11:30 a.m. to 12:45 p.m., Tuesday April 29
The Office of Mental Health is Providing Guidance for the Community Mental Health Loan Repayment Program Round 6.
OMH has launched Round 6 of the Community Mental Health Loan Repayment Program to support providers of eligible OMH licensed mental health programs in the recruitment and retention of eligible psychiatrists, psychiatric nurse practitioners, and physician assistants.
Please join us for a presentation to explore the following topics of discussion:
• Program Background & Overview
• Application Walkthrough
• Questions & Answers
 OMH has invited you to a Webex webinar that requires registration. Guidance for the Community Mental Health Loan Repayment Program Round 6 Host: OMHTuesday, April 29, 202511:30 AM | (UTC-04:00) Eastern Time (US & Canada) | 1 hr 15 mins Register Need help? Go to https://help.webex.com |