Important Budget Side Note

March 6, 2023

On Thursday, February 23, the New York State (NYS) Office of Health Insurance Programs (OHIP) at the Department of Health (DoH) hosted an informational webinar outlining the NYS Medicaid Budget Proposals for the State Fiscal Year (SFY) 2023-24 Executive Budget.  We sent all members a link to the recording and slide presentation from the webinar as soon as it became available.  The link is here for your convenience.  

—>  The Good News:  Slide #37 of the presentation (linked above) outlines 3 administrative actions the state plans to take over the next two years, to increase access to care, as follows:

(Content in green is from slide #37)

Expanding Integration of Physical and Behavioral Health – Increase access to services by: 

  • Expanding existing licensure thresholds to 30%:  DOH Article 28 D&TCs, OMH Article 31 Clinics and OASAS Article 32 Clinics and Opioid Treatment Programs to provide up to 30% physical health, mental health or substance use disorder services without obtaining a license from the regulating agency 
  • Reconstituting an integrated licensure workgroup to consider regulatory amendments to the IOS regulations to expand integration opportunities and facilitate continuation of the DSRIP models that will expire in 2025.  (Think:  DSRIP 3ai) 
  • Expanding Medicaid reimbursement for services provided by mental health professionals in DOH Article 28 D&TC settings (community health centers) permitting licensed mental health professionals to deliver direct care services to all populations. 

Please Note:  These proposals are considered ‘administrative actions’.   They do not require the blessing of the Legislature, nor must they be included in the final enacted budget in order to move forward.  These are administrative actions being taken by DoH.  

Editorial Comment:  At the present time, Article 31 and Article 32 providers can only provide up to 5% physical health services (by volume of Medicaid services in total).  This limitation has long been a barrier to the provision of integrated care for the individuals we serve.   As such, we applaud DoH for taking these steps to increase access to care and we look forward to participating on the Integrated Licensure Workgroup (mentioned above) to address long standing regulatory and other barriers that result in fragmented care for the individuals we serve.  

One last thing: The DoH also intends to come up with a plan that will extend DSRIP 3ai projects beyond 2025 (current expiration date).