March 28, 2024
1) Below please find two articles from today highlighting several NYS Council budget priorities.
2) Attached please find an Advocacy Alert requesting your assistance today in support of our request for a 3.2% COLA that is free of any limitations in terms of how the funds could be used by eligible agencies.
3) Note: Yesterday Governor Hochul issued a press statement informing New Yorkers that she has sent a temporary extender bill giving lawmakers more time to come to final agreement on a new state budget.
STATEMENT FROM GOVERNOR KATHY HOCHUL ON ONGOING BUDGET NEGOTIATIONS
“For weeks, I have been negotiating with the Legislature to craft a budget that makes record investments for New Yorkers while putting the State on a fiscally stable path into the future. While I believe a final agreement is within reach, I recognize many New Yorkers would like to spend the holiday weekend with family and loved ones. For that reason, I will be delivering a bill to the Legislature to temporarily extend the budget deadline until April 4th. Working together, I am confident we can deliver a budget that increases the housing supply, invests in schools and health care, and makes New York safer for all.”
#NYSCouncilAdvocacyWorks!!
March 28, 2024 05:33 AM AN HOUR AGO
Medicaid providers reignite efforts to overhaul ‘unnecessarily punitive’ audit process
AMANDA D’AMBROSIO, CRAIN’S HEALTH PULSE
Getty Images
Health care providers are urging the state to overhaul how it audits the Medicaid program, claiming that current protocols for administrative errors threaten to put them out of business.
The Office of the Medicaid Inspector General oversees spending in the state’s $100 billion health program, identifying fraud and clawing back money that’s been inappropriately spent. In 2022 the inspector general saved the state $3.4 billion in improper Medicaid payments. But some of the tactics used by the Medicaid oversight agency are “unnecessarily punitive” and threaten to close providers’ doors, health care groups say. Among the tactics is a process that allows the inspector general to extrapolate fines for small administrative errors like mistyping a provider identification number to large swaths of claims — and as a result, charge providers millions in fines, they added.
Nearly 50 health organizations sent a letter to Gov. Kathy Hochul and the legislature Wednesday to include a bill to reform the audit process in the final budget, which is due on April 1.
Assemblywoman Amy Paulin, chair of the health committee and sponsor of the bill, said she is pushing to include the bill in the final budget because the current audit process fines providers unfairly and threatens to erode necessary care.
“It’s bureaucracy on steroids,” Paulin said.
It’s not the first time in recent years that providers have pushed for reforms to the Medicaid audit process. The state Senate and Assembly passed legislation to reform the process in 2022, but the governor vetoed it that December. Hochul said in a veto memo that she thought the bill would hinder the inspector general’s ability to root out fraud and abuse in the Medicaid program.
But Paulin said that the bill never threatened to jeopardize the state’s ability to crack down on Medicaid fraud. Rather, she said the bill was vetoed because it was a budget issue, as preventing auditors from going after technical errors could produce a loss in state funding.
The new bill would prevent the inspector general from extrapolating fines for technical or human errors to large batches of claims. It would also give providers more time to appeal Medicaid audits, and prevent the state from taking back any funding before the appeal is complete.
The governor’s office did not respond to a request for comment about Hochul’s stance on the legislation.
“It doesn’t make sense to use tactics that are so aggressive,” said Lauri Cole, executive director of the New York State Council of Community Behavioral Healthcare, which signed the letter. Cole added that New York’s Medicaid audits are stricter than the federal government’s.
Exorbitant fines have led some programs to shut down. In 2020 Mount Sinai Beth Israel in Lower Manhattan shuttered an opioid treatment program after racking up a $7.7 million fine, Crain’s previously reported. The large penalty stemmed from 12 claims errors that produced a $400 fine.
Allegra Schorr, president of the Coalition of Medication-Assisted Treatment Providers and Advocates, which represents addiction providers in New York, said that many providers live in fear of getting a Medicaid audit that forces them to go out of business. Providers can challenge the Office of the Medicaid Inspector General, but it’s less risky to settle, she added. Many providers with little legal resources end up taking huge settlements.
“The system is not designed to produce a fair, truthful audit experience,” Schorr said. “It’s designed to extort funds from providers.”
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Governor Hochul, Legislature Must Invest in Community-Based Providers in State Budget
By NYS member associations representing more than 1,000 community-based human services organizations | March 27, 2024
Across New York, there is a force of heroes providing critical care and supports across a variety of sectors. These community-based providers serve as the backbone of delivering vital services to New Yorkers who need care for mental health, addiction, intellectual and developmental disabilities, and foster care. But they are in peril.
Years of lack of investment in these providers has directly resulted in wage stagnation, high turnover rates, widespread staff vacancies, and wait lists for services. At the same time, costs of providing high quality services have increased significantly. Rising expenses, that include significant jumps in health and property insurance, transportation, utilities, and soaring property maintenance costs, are pushing the budgets of these community-based provider agencies to their limits. In this time of need, increased state investment in these services is not just a necessity but a moral imperative to ensure that vital services continue to reach those who depend on them most.
Starting in 2006, the state recognized the need for an annual investment in the human services field and established a “Cost of Living Adjustment.” The stated purpose of this COLA was “… to improve recruitment and retention of workers employed by voluntary providers as well as provide for inflationary cost increases which has created serious workforce and other operating pressures.”
In this year’s budget, the Senate and Assembly’s proposals for a 3.2% increase, in accordance with the Consumer Price Index, is laudable. This rate increase would provide much-needed relief, helping providers keep their doors open and retain essential staff. However, providers need to retain the ability to administer the COLA in accordance with the needs of their agency. For instance, using it to avoid passing increased health insurance costs to staff. It is crucial that this COLA remains flexible, recognizing the diverse needs of providers across different industries and regions.
Community-based providers that serve our most vulnerable need more resources to pay and retain staff and provide relief for inflationary cost increases.
Therefore, alongside the 3.2% COLA, our respective organizations have called for targeted investments in our workforce. Livable wages are a necessity, essential for attracting and retaining the skilled and dedicated individuals who deliver critical services to our communities.
We urge the Governor and the Legislature to heed our call. The time for action is now. We must stand together to support our nonprofit community-based providers, ensuring that they have the resources they need to continue their vital work.
Signed by thirteen NYS member associations representing more than 1,000 community-based human services organizations providing care for individuals with intellectual and developmental disabilities, mental health and/or substance use disorder, and youth in foster care.
Mike Alvaro
President, New York Disability Advocates
Sebrina Barrett
Executive Director, Association for Community Living
Kathleen Brady-Stepien
President & CEO, The Council of Family and Child Caring Agencies
Lauri Cole
Executive Director, NYS Council for Community Behavioral Healthcare
Sharon Horton
Executive Director, NAMI-NYS
Jihoon Kim
CEO, InUnity Alliance (formerly the Coalition for Behavioral Health and ASAP-NYS)
Pascal Leone
Executive Director, Supportive Housing Network of NY
Glenn Liebman
CEO, Mental Health Association of New York State
Jackie Negri
Executive Director, New York State Care Management Coalition
Paige Pierce
CEO, Families Together in NYS
Harvey Rosenthal
CEO, The Alliance for Rights and Recovery
Allegra Schorr
President, Coalition of Medication-Assisted Treatment Providers and Advocates of NYS
Kayleigh Zaloga
President & CEO, NYS Coalition for Children’s Behavioral Health