October 27, 2021
Following is a Public Notice posted this morning in the NYS Register pertaining to (federal) eFMAP funds received by NYS for purposes of enhancing and increasing access to HCBS SUD services across New York.
Putting aside the confusing language in the announcement, you can see that the state’s intention is to temporarily increase rates for Residential Addiction Rehab Services and Outpatient Addiction Rehab Services, as well as rates for state-plan approved Addiction Services shortly. Again this is eFMAP funds which can only be used to increase rates for Rehab Services.
The state must spend the funds quickly so it is possible that providers will receive the bulk of the increases due to them in a short amount of time. It all depends on how long the state has to spend the money. Ideally, the state will receive permission to spend the funds over a longer period of time and then simply amend the public notice to reflect this. Butt at this time it is unclear what CMS will say.
The third item in the announcement is a bit confusing since it appears to begin with a sentence written in the past tense. This confuses me so I have asked Trisha Schell-Guy for clarification on the third bullet in the Notice. Stand by.
Department of Health
Pursuant to 42 CFR Section 447.205, the Department of Health hereby gives public notice of the following:
The Department of Health proposes to amend the Title XIX (Medicaid) State Plan for non-institutional services to enhance and increase access to Home and Community Based Services (HCBS) in accordance with the federal statutory provisions of Section 9817 of the American Rescue Plan Act of 2021 (ARP) which, subject to approval of the State’s initial spending plan and narrative (Spending Plan) by the Centers for Medicare and Medicaid Services (CMS), provides a ten percent increase in Federal Medical Assistance Percentage (FMAP) to state Medicaid programs from April 1, 2021 to March 31, 2022 to supplement existing state expenditures on HCBS. The following changes are proposed:
Contingent upon CMS approval of the Spending Plan submitted by the State, effective on or after November 1, 2021, this notice proposes to increase reimbursement rates, as follows:
1) Residential Addiction Rehabilitation Services. To allow for the full disbursement of funds available April 1, 2021 – March 31, 2022, rates for state-plan approved residential addiction rehabilitation services provided in 820 stabilization and reintegration services will be increased by ten percent, for the period November 1, 2021 – December 31, 2021. Rates will then be reduced 10 percent effective January 1, 2022. This enhancement will allow providers to supplement the implementation of one or more activities to enhance, expand or strengthen HCBS under the Medicaid program, including strengthening the response to the COVID-19 Public Health Emergency, assisting providers in meeting the challenges of serving the highest need individuals including but not limited to, those suffering from opioid
addiction, dually diagnosed individuals or individuals with multiple comorbidities.
The estimated annual net aggregate increase in gross Medicaid expenditures as a result of the proposed increase for Residential Rehabilitation Addiction Services is $41,420,118.34.
2) Outpatient Addiction Rehabilitation Services. Rates for state plan approved Outpatient Addiction Rehabilitation Services provided to individuals in the community will be temporarily increased by an additional 10 percent for the period November 1, 2021 – December 31, 2021. This enhancement will allow providers to increased patient engagement and access to services for those who are unwilling or unable to otherwise engage in care. The estimated annual net aggregate increase in gross Medicaid expenditures as a result of this proposed increase for Outpatient Addiction Rehabilitation Services $11,834,319.53.
3) Rates for state-plan approved Addiction Services increased by an additional 10 percent for the period November 1, 2021 – December 31, 2021. This enhancement will allow providers to increase recruitment and retention of experienced and dedicated direct care and other staff through measures including, but not limited to, targeted loan forgiveness, tuition reimbursement, hiring and signing bonuses, longevity payments, continuing education assistance, shift differential pay and retirement contributions.
The estimated annual net aggregate increase in gross Medicaid expenditures as a result of this proposed increase for Addiction Rehabilitation Services $21,301,775.15.
The public is invited to review and comment on this proposed State Plan Amendment, a copy of which will be available for public review on the Department’s website at http://www.health.ny.gov/regulations/state_plans/status. Individuals without Internet access may view the State Plan Amendments at any local (county) social services district.
For the New York City district, copies will be available at the following places:
New York County
250 Church Street
New York, New York 10018
Queens County, Queens Center
3220 Northern Boulevard
Long Island City, New York 11101
Kings County, Fulton Center
114 Willoughby Street
Brooklyn, New York 11201
Bronx County, Tremont Center
1916 Monterey Avenue
Bronx, New York 10457
Richmond County, Richmond Center
95 Central Avenue, St. George
Staten Island, New York 10301
For further information and to review and comment, please contact:
Department of Health, Division of Finance and Rate Setting, 99
Washington Ave., One Commerce Plaza, Suite 1432, Albany, NY