HEADS UP: Increased Rates for PROS – PUBLIC NOTICE

October 13, 2021

In today’s State Register page 81:

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:

Non-Institutional Services

Contingent upon CMS approval of the Spending Plan submitted by the State, effective on or after October 14, 2021, this notice proposes to increase reimbursement rates as follows:

Rates for state-plan approved Personalized Recovery Oriented Services (PROS) will be increased by 10.30 percent annually, effective October 14, 2021. However, to allow for full disbursement of funds available April 1, 2021 – March 31, 2022, the rate increase for the period October 14, 2021 – March 31, 2022 will be an additional 12.00 percent, for a total increase of percent. Rates will then be reduced 12.00 percent effective April 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, but not limited to, strengthening the response to the COVID-19 Public Health Emergency, assisting providers in meeting the challenges of changing population demographics, and enhancement of their programs, including but not limited to providing services with higher staff to recipient rations and at offsite locations.

The estimated annual net aggregate increase in gross Medicaid expenditures as a result of this proposed increase for PROS is $8,100,000.

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, expanded student placements, shift differential pay and retirement

The estimated annual net aggregate increase in gross Medicaid expenditures as a result of this proposed increase for PROS is $5,500,000.

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 12210, spa_inquiries@health.ny.gov