Early Returns – Senate One House Budget Bill

March 12, 2024

This information is subject to change – the Senate Resolution came out late last night and we are still analyzing proposals in the bill.

Here’s a brief first look at what we see in the Senate one-house bill with more detail to follow later today:

  • The Senate budget bill supports COLA being increased to 3.2 % (from Governor’s original proposal of 1.5%) however it restricts the use of these funds solely to increase the hourly and/or salary wages of non-executive direct care staff, non-executive direct support professionals, and non-executive clinical staff.
  • The Senate budget bill INCLUDES our Commercial Rate Mandate proposal (Part AA).
  • The Senate BILL INCLUDES our OMIG Audit Reform language.  (See  S. 5329-C – Harckham)
  • The Senate rejects the executive proposal that would require the state to implement a Competitive Procurement process to identify health plans/insurers that manage benefits in the state’s Medicaid managed care program.  
  • Senate rejects executive proposal that increases penalties on insurers for failure to comply with the state’s Model Contract (governs the Medicaid managed care program).
  • MCO TAX – Senate bill includes language that would require the state to seek approval from CMS for a new MCO Tax (see our email from Saturday, March 9 on this topic) for a 3-year period. However, the Senate language appears to exclude OPWDD Article 16, OMH Article 31 and OMH Article 32 providers from benefiting from this initiative.  Remember: Our analysis on this topic (sent on Saturday) states the Assembly is also considering the tax. We have yet to see the Assembly language on this topic. Specifically, the Senate bill proposes:
    • 3% rate increases for all DOH Medicaid payments on and after 4/1/24 plus:
      • additional 7% for hospitals
      • additional 6.5% nursing homes, assisted living programs and hospice.
    • This tax is expected to yield approximately $4 Billion in additional Federal Financial Participation (FFP) per year for three years.
  • Senate bill establishes a youth mental telehealth program for access to MH and SUD services. 
  • The Senate modifies the Executive proposal to combat the unlicensed sale of cannabis by adding language that would strengthen the ability of enforcement agencies to take actions against property owners allowing illicit cannabis stores on their property, make it easier for local governments to utilize the process to seek closing orders against illicit stores in the courts, expand the hours when administrative inspections can happen, and makes technical changes to the proposal to give localities the ability to create their own administrative cannabis enforcement local laws.
  • Senate adds FQHCs to existing provision re:  telehealth language that requires reimbursement for telehealth services at the face-to-face rate.
  • Requires at least 10% of opioid stewardship fund $ to be invested in recovery services and supports. ‘To supplement, not replace other funds.’ Adds reporting requirement.
  • Senate accepts executive budget proposal that would impose higher penalties on health insurance companies that willfully violate mental health parity laws and regulations.
  • Senate bill modifies the Executive proposal that would sunset the State’s COVID-19 Sick Leave Law on July 31, 2024, by continuing such benefits for employees that work in facilities licensed under Article 28 of the Public Health Law.
  • Senate bill adds $2M for Daniel’s Law Pilot Program grants.
  • The Senate modifies the Executive proposal to make the Community Mental Health Support and Workforce Reinvestment Program permanent by extending the program an additional three years and requires annual reporting on certain performance metrics.
  • The Senate modifies the Executive proposal to make the Comprehensive Psychiatric Emergency Programs permanent by extending the program an additional three years.

The Senate modifies the Executive All Funds recommendation of $922.3 million by adding $67.9 million for a total of $990 million as follows:

  • The Senate adds $45 million to support the Opioid Settlement Fund with appropriation language to support programs recommended by the Opioid Advisory Board.
  • The Senate adds $11.4 million for Problem Gambling, Substance Use Disorder Outpatient, Harm Reduction, and Treatment Support Services.
  • The Senate adds $5 million for Cannabis Youth Education programs and services.
  • The Senate adds $5 million for Addiction Services and Support Legislative Grants.
  • Senate advances certain provisions that would direct the Office of Addiction Services and Supports to contract with a vendor to establish a drug-checking services program. (New Part ZZ).