The Department of Budget (DOB) has now approved the 2.6% Targeted Inflationary Increase (TII) enacted in the State Fiscal Year (SFY) 2025-26 budget, effective April 1, 2025. The NYS Council has strongly supported annual TIIs for providers.
All Medicaid Managed Care Plans, HARPs, HIV SNPs, and MAP Plans (collectively referred to as “MMCPs”) are required to pay claims based on the effective date of the rate changes. As a result, MMCPs must complete necessary system edits to ensure payable claims with dates of service on or after April 1, 2025, for applicable programs are reimbursed accurately and timely. Additionally, MMCPs are required to conduct retrospective reconciliation to adjust payments for clean claims as necessary. MMCPs must complete these activities as soon as possible, but no later December 24, 2025.