June 3, 2025

With just 7 session days left in the regularly scheduled 2025 Legislative session, the NYS Council continues to track, support and/or lead advocacy campaigns designed to move important legislation forward.  Here’s a status report on several bills we are focused on:

MMC CARVE OUT LEGISLATION (S8309 (Brouk)/A8055 (Simon)

Last Friday we finally saw the introduction of the Senate version of our Medicaid managed care carve out bill.  We had waited a long time for the bill, sponsored by Senator Samra Brouk, to be assigned a bill number (S8309) while the Assembly version had previously been introduced on April 22 (A8055) by our sponsor Assemblywoman JoAnn Simon.  In the remaining days of the legislative session we will work to educate lawmakers and advocate for the bills (currently in the Health Committees) to move forward.  While it is unlikely we will see both bills pass in their respective houses we need to push this legislation aggressively.  The serious barriers presented by the continued carve-in of most OASAS and OMH outpatient services is an ongoing atrocity where there is no value add associated with mostly for-profit companies managing benefits for New Yorkers in need of care through the public mental hygiene system, where participating plans earn (at a minimum) 11% profit (admin overhead + profit), and where often fail to follow the laws, regulations and guidance governing the carve in.  Returning these services to a fee for service reimbursement model would save New York State a minimum of $400M/year that could be returned to our service delivery system and we desperately need these resources to invest in our workforce, and to expand access to care.

OMIG Audit Reform:  S4955A (Harckam)/A1069A (Paulin)

This bill would bring much-needed transparency and due process to Medicaid provider audits by the Office of the Medicaid Inspector General (OMIG). The current audit process is excessively harsh in cases where a few minor clerical errors, not fraud, lead to the extrapolation of millions of dollars in recoveries, forcing some behavioral health providers to close.

Commercial insurance Coverage of BH Services S.5241 (Fernandez)/A.6648 (Hunter)

This bill would reduce barriers to commercial insurance coverage of behavioral health services by requiring insurers to use transparent, evidence-based criteria and prohibiting denials of approved care.  The bill is in the Insurance Committee on the Senate side however, it has not been assigned to a committee in the Assembly to date.

QMHP Scope of Practice and Supervision  A.780 (Berger)/S.6999 (Stavisky)

This bill would allow qualified mental health practitioners who have been granted the diagnostic privilege to provide supervision for Licensed Clinical Social Worker (LCSW) candidates. Expanding the pool of potential supervisors will remove an unnecessary barrier to licensure without compromising the quality or safety of mental health care—in fact, it will ensure continued access to quality care for thousands of New Yorkers.

Additional Time for LMHPs to Obtain Diagnostic Privilege A8045 (Bronson) /S7622 (Fernandez)

This legislation will ensure continuity of care beyond June 2025 for thousands of New Yorkers who need mental health and substance use disorder services through the public mental hygiene system by enabling licensed mental health practitioners who are currently allowed to diagnose and produce assessment-based treatment plans under supervision to continue to do so through June 2027, allowing a more reasonable amount of time for those interested in pursuing the diagnostic privilege to be approved by an overburdened State Education Department (SED) application process. Given the backlog at SED and ongoing behavioral health workforce shortages, the extension is needed to minimize treatment disruptions for New Yorkers receiving behavioral health services.

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FEDERAL UPDATE:  Senate moving on House Megabill

Senate Schedule:  Budget Reconciliation

Senate committees will start rolling out their portions of the GOP megabill as soon as today, providing a first look at how Republicans in the chamber plan to address some of the House’s most controversial proposals.  According to senator John Thune, the idea is to have the committees with the least controversial changes go first. Accordingly, the Finance Committee, which has jurisdiction over controversial changes to Medicaid and tax cuts, is widely expected to be among the final committees to release its portions of the megabill – if not the very last.  

The accelerated pace reflects both potential back-channel dealings and pressure on Majority Leader John Thune to get the Senate to pass the legislation.  Thune, who met with Trump yesterday, said the bill is “most likely” coming to the Senate floor the last week before the July 4 holiday recess. 

Here’s the draft-text timeline for this week from Politico, though it could change:

— Armed Services on Tuesday

— Environment and Public Works on Wednesday

— Commerce on Thursday

— Banking on Friday

The scheduling logic: Just as the House sequenced its megabill markups from least-to-most controversial to buy lawmakers more time to resolve their stickier policy debates, the Senate will have committees release their least-contentious draft bills first. Finance, which has jurisdiction over tax cuts and changes to Medicaid, is widely expected to be among the final Senate panels to release text, if not the last.

The massive tax-and-spending package will “most likely” hit the Senate floor the last full week of June, ahead of the July 4 recess, per Majority Leader John Thune.

It could come even sooner — but that depends on how conversations go with the Senate parliamentarian, Elizabeth MacDonough. Committee staffers started vetting the megabill with MacDonough last week, and will continue their talks this week and next. MacDonough’s job is to recommend which House-passed provisions and policy priorities must be dropped to comply with the strict rules governing the filibuster-skirting budget reconciliation process.

Thune signaled Monday that Republicans won’t seek to override their referee if they don’t like her rulings. But he said he hoped MacDonough could be convinced to greenlight inclusion of the so-called REINS Act “in some fashion.” The longstanding conservative proposal would give Congress more authority to approve agency regulations.

The chamber’s lightning-fast turnaround nods to the weeks of behind-the-scenes work by GOP senators and their aides to prepare for the domestic policy bill’s arrival from across the Capitol. It also shows the immense pressure they’re under from the White House to get moving on advancing President Donald Trump’s sweeping legislative agenda.

The president is starting to play his own hand. Trump met separately Monday at the White House with both Thune and Sen. Rick Scott, who wants deeper spending cuts but told Lisa “we all want to get a bill done.” Trump also spoke by phone with Sens. Ron Johnson, who’s pushing a return to pre-pandemic spending levels, and Josh Hawley, who’s opposed to some of the Medicaid changes endorsed by the Republican House. And Jordain reports the president will likely meet with Thune and Finance Chair Mike Crapo either this week or next to talk through the details of the tax portion of the bill.  (Source:  Politico, Roll Call)

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Work requirements penalize workers in volatile occupations

 Low-income workers in industries like the service sector often don’t have complete control of their employment hours, which can shift seasonally or even from week to week. Proposed monthly work-hour requirements for programs like Medicaid could penalize these workers, write Elizabeth Ananat, Anna Gassman-Pines, and Olivia Howard in a new brief.