Budget Update

May 2, 2023

Good morning,

1.  The NYS Legislature has begun voting on budget bills but it has not concluded the process despite the fact that the current budget extender only allows the state to extend current year budget spending through today.  In these instances, we often see federal and state lawmakers employ a tactic in which they load up one or two bills that carry budget language from all areas of the budget that haven’t gotten a vote yet.  In Albany, we call this process ‘The Big Ugly’.  It is likely this process will be used to avoid lawmakers having to pass another budget extender through at least Thursday.  For more on ‘The Big Ugly’, use this link:  https://nystateofpolitics.com/state-of-politics/new-york/ny-state-of-politics/2020/01/17/what-are-they-talking-about–a-guide-to-albany-isms-at-the-capitol

2.  Earlier this year, we circulated a budget document, the FY ’24 Medicaid Scorecard, that tracks Medicaid-related actions in the state budget.  The Scorecard that came out shortly after the executive budget proposal was released listed a group of Medicaid actions that would be taken if the executive proposal were to be implemented as proposed.

Attached please find an updated FY ’24 Medicaid Scorecard that shows the proposed executive action, how the Assembly and the Senate one-house bills responded to the proposal (did they include it in their one house budgets and if so, at what level?), and the final outcome based on the final budget agreement.

As you will see there are a number of Medicaid-related actions on the Scorecard that are of import to NYS Council members including the following:

  • CPEP expansion
  • ACT expansion
  • DoH Health Home ‘recalibration’ over two years
  • FQ funding to address impact of NYRX implementation
  • DTC funding to address impact of NYRX
  • Ryan White Program funds to address impact of NYRX
  • Hospital rate increase
  • Nursing Home rate increase
  • Health Home+ Program Expansion
  • CCBHC Demo Expansion
  • New CCBHC Demo Indigent Care Pool (there is state money made available regardless of federal share)
  • Rate increases for school-based mental health clinics and kids day treatment programs (25% for both)
School-based Mental Health Clinics & Kids Day Treatment Programs
Regarding the above reference to increases for school-based mental health clinic rates and kids day treatment rates (below), the rate increase is confirmed at 25% for both.  The rate increases would be effective as of 7/1/23.  There will be OMH billing guidance to follow.
And to reiterate, the budget also includes an insurance-related change impacting school-based MH clinic provider reimbursement policies.  It requires commercial plans to pay the Medicaid APG government rate in instances where the school-based MH clinic is serving a child/youth with commercial insurance coverage.
OMH is working to get out a broader blueprint/schedule of all types of RFPs and opportunities the Office will be offering over time.  In terms of the CCBHC Demo expansion that is included in the final budget, it sounds like the state would like to put out 2 RFPs for the additional 26 CCBHC Demos in this calendar year, however the intention appears to be to ‘turn on’ roughly 13 new CCBHC demos this year, and 13 or so next year.  
Medicaid managed care enforcement
There is another $37M for OASAS and $74M for OMH in the new budget agreement thanks to our advocacy efforts to compel the state to recoup overpayments from Medicaid managed care plans that are not meeting expenditure targets, as contractually required.  
As demonstrated above, #NYSCOUNCILADVOCACYWORKS!