September 8, 2025

CONFIDENTIAL – PLEASE DO NOT SHARE THIS EMAIL OR ITS CONTENTS OUTSIDE OF YOUR AGENCY

Good morning,

Last week was a blur and we did not have a chance to update NYS Council members regarding a number of important advocacy efforts we have initiated on your behalf.  Please see below:

New OASAS PAS 47M Reporting Requirements

On September 3, 2025, OASAS sent a notice to certain OASAS providers regarding a fast approaching implementation date for a new OASAS reporting requirement utilizing the PAS 47M  that allows OASAS to gather information about the use of Medication Assisted Treatment (MAT) for clients of OASAS Outpatient, Opioid, and Residential service programs.  The new requirement is effective October 1, 2025.   (See the Notice attached in case you missed it when we first sent it.) 

Upon receipt of the notification we immediately began receiving complaints from Council members regarding this new requirement that appears to add additional workload to already overburdened agencies at a time when we can ill afford even the slightest increase in administrative workload and additional unfunded mandates.  OASAS members are already challenged by so many reporting requirements and this additional requirement does not seem to serve a purpose other than requiring reporting that can be found in a progress note.  All of this runs contrary to the message the Offices (including OASAS) have been broadcasting about their interests in cutting down/streamlining new and existing regulatory requirements in the face of massive workforce shortages and increased risks to provider viability due to the coming implementation of various provisions in HR1 – the OBBA.  

According to the OASAS Notice, impacted programs must use the PAS-47M data collection screen in the CDS Client Management section to enter individual transactions for each client receiving MAT, and “batch submission is not available at launch but will be implemented in the near future.”  This is not a realistic or (frankly) fair requirement.   

Later this morning the NYS Council will send a letter to Commissioner Chinazo Cunningham requesting a delay of the implementation of the new PAS47M requirement until such time as batch reporting is available and working properly, and until OASAS can confirm that the majority of OASAS providers impacted by this new requirement are ready to go.  We will also request that a delay continue until after the field has  met with OASAS leaders to identify solutions to the (current) serious drain on resources associated with this new requirement.  Stand by.

CCBHC Demo and SCN

Thanks are due to the NYS Council member agency representative in WNY who recently called me to discuss an ongoing concern in which some CCBHC Demo agencies believe they cannot screen, case manage and navigate Demo clients that could benefit from SCN services such as housing, food, and transportation to the SCN  because the CCBHC PPS rate bundle already includes payment to the Demo provider (PPS rate) for general screening, navigation, and enhanced case management services.   The provider I spoke with said:  “While we are aware that specific enhanced services like housing, food, and transportation are not bundled in the CCBHC PPS, we can’t provide them through the SCN system because screening and navigation is required to get the client into the SCN system (where the provider is automatically be paid for screening, navigation and case management services).  Therefore, providers are rightly concerned about a perception that the Demo agency is somehow “double could benefit from HRSN services, and we agree.  When we learned of this problem we immediately went to the state and pressed for clear guidance that confirms the rules of the road as soon as possible.   State reps from DoH and OMH met earlier this week and I have received verbal confirmation that there is no prohibition that would preclude Demo agencies from screening and navigating a client to the SCN system and being paid to do so.   I’m told DoH and OMH are working on language to clarify this issue, and it will be circulated to providers, SCNs, etc. within the next few weeks but possibly as early as next week.  Until you see it in writing, I would suggest you do nothing but I want you to know we are fighting another good fight for access to critical services for New Yorkers who could benefit from enhanced HRSN services through the 1115 waiver.   THANK YOU to the NYS Council member agency that brought this to my attention.  

Concurrent Review and CAFTAS Services

Beginning in June, the NYS Council notified OMH representatives that several MCOs had sent a notice to their in network CAFTAS providers stating that they were going to be requiring their in network providers to go through a concurrent review process for certain of these services.  (At this time I am aware of 3 MCOs that have implemented concurrent review – Fidelis, United and HealthFirst).  When notified, some NYS Council member agencies inquired of the MCO as to why they were being required to go through this process in order to continue care for the MCOs insured. At that point, some providers were told they would be excused from concurrent review for these services while others were told they had to comply without an explanation as to why.

When we began pushing OMH to respond to our questions about health plan implementation of this utilization practice, we stated that we had significant concern that this new requirement may be a parity violation.   We asked for technical assistance and an explanation from the Office.  In my opinion it has taken far too long for OMH to respond.  Last week I received a response that I’ve taken to our legal team who will advise further.  

The NYS Council also complained to DoH and OMH about the lack of plan surveillance and monitoring that should have been implemented from Day 1.  In our opinion permitting the MCOs to implement this requirement in the absence of a robust and immediate surveillance and monitoring plan that focuses on health plan compliance with acceptable utilization review practices, is not in the best interest of children and families served by our member agencies.  We made this clear and OMH states it will begin to monitor plan compliance with the rules for implementation of concurrent review shortly, while we continue to escalate our concerns over this being a possible parity violation, alongside our legal team.

REQUEST:  We would like to hear from NYS Council members who are now subject to the concurrent review process being required by certain MCOs for some CAFTAS services.  Specifically we are am interested in:

• How it’s going? Is the process efficient?  
• How long does it take from the time you request additional units of services and when there is a decision on your request from the insurer? 
• When you request additional units of service in order to continue care for a client-family, what % of those requests are granted? 
•  What are the additional expenses (staff time, money, technology changes you have had to make) to comply with this new requirement?  

New York’s Application for funds through the (federal) Rural Health Transformation Program (RHTP) 

According to an analysis performed by Becker’s Hospital Review, approximately 51% of all NYS hospitals are currently at risk of closure and 16 of these hospitals (33%) are currently at immediate risk within the next 2-3 years.  HR1 – the so-called OBBB included $50B over the next 5 years to address rural hospital needs however approximately 50% of these funds will also be available to secure other areas of healthcare (in addition to hospitals) through a competitive application expected to hit the streets here in New York and around the country next week.  The turnaround time for NYS to apply for these funds is tight.  Over the last few months we’ve sent information about the Rural Health Transformation Program to all members (see attached).  Last week I got myself invited to a meeting hosted by DoH leaders that brought together external stakeholders including hospital, nursing home, and other representatives, to discuss their ideas for projects NYS should consider including in its RHTP application.  

More about the Rural Health Transformation Program.  There are 10 priority areas for funding (including Behavioral Health) however, there are many nuances and limits built into this Initiative.  Providers should be aware that these funds are non-recurring beyond the 5 year period of the Program, so stakeholders with recommendations must also put forward a recommendation for sustainability after the funds are depleted.  Also, until the announcement comes out from the federal government we do not know which of at least 3 different definitions the state is currently aware of, will be employed by the federal government to define areas of the state that can receive funds.  Finally, there is a prohibition on using these funds for major capital projects.  

On Thursday morning (9/11 at 9:15) we will be meeting for our NYS Council Member Support call and during the meeting to discuss the RHTP in greater detail.  

Of note:  A new report issued by State Comptroller Thomas P. DiNapoli last month examined healthcare professional shortages in 16 rural counties in New York state and found alarming shortfalls in primary care, pediatric, and obstetrician and gynecologist (OBGYN) doctors, dentists and mental health practitioners, with several counties having no pediatricians or OBGYN doctors at all. The shortage of mental health practitioners in New York’s rural counties may be the most severe, with all counties designated by the federal government as areas having professional shortages.  The rural counties examined were Allegany, Cattaraugus, Chenango, Delaware, Essex, Franklin, Greene, Hamilton, Herkimer, Lewis, Schuyler, Steuben, Sullivan, Washington, Wyoming and Yates.

Please make a note to attend our Thursday morning call this week, beginning at 9:15.  This will be an important gathering of our members to discuss the RHTP and several other federal and state issues that are percolating.  Slides are included below for your review prior to the Thursday morning meeting.