MHOTRS Quality Improvement Collaboratives (QIC)
May 10, 2024
Two documents attached and Notification Memo to MCOs, etc. re: QIC (below).
Subject: Mandated Rate Update: Mental Health Outpatient Treatment and Rehabilitative Services (MHOTRS) Quality Improvement Collaboratives (QIC)
MEMORANDUM
TO: Mainstream Medicaid Managed Care Plans, Health and Recovery Plans (HARPs), HIV Special Needs Plans (HIV SNPs), and Medicaid Advantage Plus (MAP) Plans
FROM: New York State (NYS) Office of Mental Health (OMH)
DATE: May 10, 2024
SUBJECT: Mandated Rate Update: Mental Health Outpatient Treatment and Rehabilitative Services (MHOTRS) Quality Improvement Collaboratives (QIC)
____________________________________________________________________________
Dear Health Plan Administrators,
Effective October 1, 2023, the MHOTRS rates for free-standing providers participating in the OMH QIC Initiative are increased by 1.86%, bringing the total enhancement percentage from 3.84% to 5.7%. Additionally, hospital-based MHOTRS providers with QIC will also be eligible for the enhancement at the same total amount of 5.7%. These increases are consistent with the State Fiscal Year (SFY) 2023-2024 Enacted State Budget and will be reflected in premiums upon NYS and Federal approvals.
OMH’s QIC projects aim to build on the success of past OMH QIC projects, align with statewide priorities to improve health- and behavioral health-related outcomes for the NYS Medicaid population, and harness the expanding capacities of the OMH Psychiatric Services and Clinical Knowledge Enhancement System (PSYCKES) application. The enhanced APG peer group base rates are available for all fee-for-service and Medicaid managed care services provided in the OMH-licensed clinic.
This letter is to alert Mainstream Medicaid Managed Care Plans, Health and Recovery Plans, HIV Special Needs Plans, and Medicaid Advantage Plus Plans (collectively referred to as “MMCPs” herein) of the adjustments to ensure compliance with the statutorily required payment of government rates. NYS will issue an additional notification to MMCPs upon Division of Budget (DOB) approval.
Please refer to the attached Appendix A – List of QI Providers 05.10.2024 for a list of MHOTRS Hospital and Freestanding providers in receipt of the QI enhancement and corresponding rates. The QI rates can also be found in the APG Peer Group Base Rates file on the OMH Medicaid Reimbursement page.
Please note that this document is only being transmitted electronically. No hard copy will be forthcoming. If you have any questions regarding these rate changes, please contact OMH Managed Care at 518-402-2822 or BHO@omh.ny.gov.
Thank you.
Office of Mental Health
Division of Managed Care
44 Holland Avenue, Albany, New York 12229