April 14, 2022

Here is what we heard this morning:

1) The link below lists some of the many OMH rate changes due to eFMAP & OMH will be updating this info to include COLA @5.4% shortly.  Will also be updating to reflect residential housing rate changes shortly.

https://omh.ny.gov/omhweb/medicaid_reimbursement/

OMH Outpatient Clinic rate changes

Outpatient Clinic Increases are composed of:  5.4% COLA increase  (permanent – increases APG base rates) + 5% eFMAP increase (permanent, increases APG base rates) AND for 8 months, another 10% increase (temporary workforce increase that increases APG base rates).

So, it’s 10.67% (when compounded) that is permanent PLUS another 10% for 8 months (retro to January and ending September).  NOTE:  In September clinic rates will change (decrease) to reflect the end of 8 month temporary increase.

Funds NYS Council advocated to be returned to OASAS and OMH from MCOs failure to meet expenditure targets will be used to make the permanent 5% eFMAP increase (discussed above) that would otherwise have been temporary, permanent.  FYI:  Our efforts resulted in OMH getting back $74M state share that grosses to $148M; OASAS got back $37M state share that grosses to $74M = $222M total for MH and SUD systems of care.

Healthcare Workforce Bonuses (enacted as part of new state budget)

Up to $3,000/employee. See language re:  eligible employees.  

This is a multi-state agency initiative and so (internally) state leaders are meeting to iron out implementation across the healthcare landscape.

Can be distributed to staff over time – does not have to go out from your agency as lump sum payment to staff.  

Eligible if earn less than $125k and meet other eligibility requirements in terms of vesting, job title.

eFMAP Rate Changes

Permanent rate changes include:  PROS (10%)  ACT (5%) and Community Residences (5%), effective 4/1/2022 – all have been approved by CMS and are retro to October 1, 2021.

Note:  There are additional rate increases coming for OMH housing providers beyond this amount.  

COLA (enacted as part of new state budget)

5.4%  – mostly rate changes (CR’s not Medicaid funded but will get $65M.)  

Health Home+  is eligible.  DOH regulated HHCM not included.  NYSSHP (overseen by OTDA) not included.

ACT

There is some deficit funding (state aid) in ACT but the 5% increase (mentioned above) is only on the Medicaid portion of the ACT rates.