October 17, 2022

The NYS Council has been pushing (and pushing) for the announcement (below) that pertains only to federal CCBHC DEMO agencies. This letter is not directed to Expansion Grant awardees.

In related news, NYS has not yet received the package of information and the actual application CMS said it would release this month so that states that are part of the original federal DEMO can apply to expand the number of DEMO clinics in their states if they so choose.  Compelling NYS to open the demo opportunity to all eligible NYS Outpatient Clinics is a huge priority for the NYS Council.   We will keep an eye out the application information from CMS.
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Dear CCBHC Provider –

In August each CCBHC provider received notification that CMS had notified NYS that an uncompensated care adjustment was not permitted in the CCBHC Medicaid rates, and that an alternative proposal was being development for submission to CMS for approval.  Since that date a proposal has been submitted, and there have been several follow-up conversations with CMS to address questions they had about what was submitted.  However, as of this date this proposal has not yet received a final determination from CMS.

As we are aware of the financial strains being experienced by the CCBHCs because of the length of time that has passed as we have negotiated with CMS, we are moving forward with a Medicaid rate package seeking approval of the following updates to the CCBHC Medicaid rates:

• DY4 Medicaid rates:  calculated using the approved DY3 Medicaid rates increased by the Medicare Economic Index (MEI) of 1.328%.
• DY5 Medicaid rates:  calculated using the proposed DY4 Medicaid rates increased by the MEI of 1.343%.  This proposed change differs from the original proposal to re-base the DY5 Medicaid rates using the information from the DY3 CCBHC Cost Report.

In accordance with Mental Hygiene Law, the proposed rates must be approved by the Department of Health and the Division of the Budget before we can load them in MMIS, so this information is for your information only. 

If the required approvals are obtained you will receive a formal notice of the new rates for your CCBHC, and the rates will be uploaded into eMedNY and all CCBHC claims paid since July 1, 2020 will be re-adjudicated at the appropriate new rate amount.  These new rates will result in a retroactive positive adjustment to both rate periods.

If you have any questions please let me know.

Bob

Robert E. Blaauw

OMH CCBHC Project Team

NYS Office of Mental Health