June 3, 2024

Our OMIG Audit Reform bill is on the Senate Active List and is likely to receive a full house before the end of the legislative session (June 6).  As we discussed during last week’s NYS Council Member Support & Public Policy discussion, Assembly central staff have resisted moving the bill due to the financial implications associated with passage of the bill that would infuse transparency, balance and fairness into the audit process and inevitably lead to reduced takebacks.  We have amended the bill 5 times in response to legislative and executive concerns brought to us.  The latest version pushes out the implementation date of the bill to 2026 so the state has time to find other sources of funding to plug financial holes. There is simply no justification (not that there ever was) for the state’s continnued reliance on OMIG audits to fill state budget gaps at the expense of essential safety net providers that have not been accused of Medicaid fraud.

S5329E – HARCKHAM
Relates to the functions of the Medicaid inspector general with respect to
audit and review of medical assistance program funds and requiring notice of
certain investigations
Currently on Senate Active List.
**Also on the Senate Active list, S6733 (Rivera) would include FQHCs on the list of provider types that will be paid at the face-to-face rate for telehealth services.  The Senate bill would make this a permanent addition, however during the state budget process state lawmakers agreed to continue the availability of telehealth services as currently permitted through 2025.  
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Today at 11:00, Dr. Chinazo Cunningham will speak with WCNY’s David Lombardo, host of the Capitol Connection, about overdose death rates, funding distributed by her office, and access to opioid reversal agents. Here’s a link:  https://capitolpressroom.org/?mc_cid=6c477295c6&mc_eid=101f23c33c
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May 31, 2024­­­­­

OCR Updates Change Healthcare Cybersecurity Incident FAQs

Today, the U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) published an update to the frequently asked questions (FAQs) webpage concerning the Change Healthcare cybersecurity incident. The webpage, first published on April 19, 2024, provides answers to FAQs concerning the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Rules and the cybersecurity incident impacting Change Healthcare, a unit of UnitedHealth Group (UHG), and many other health care entities.

OCR enforces the HIPAA Privacy, Security, and Breach Notification Rules, which sets forth the requirements that HIPAA covered entities (health plans, health care clearinghouses, and most health care providers) and their business associates must follow to protect the privacy and security of protected health information and the required notifications to HHS and affected individuals following a breach.

“Ensuring patient privacy is one of the pillars of HIPAA. Our updated FAQs webpage on the Change Healthcare breach reiterates that importance by making clear that individuals affected by this breach must be notified that their protected health information was breached. This ensures that the potentially millions of Americans, including the elderly, the disabled, those with limited English proficiency, those with limited access to technology, and more, will understand the impact of this breach on their private medical records and their health care,” said OCR Director Melanie Fontes Rainer. “Affected covered entities that want Change Healthcare to provide breach notifications on their behalf should contact Change Healthcare. All of the required HIPAA breach notifications may be performed by Change Healthcare. We encourage all parties to take the necessary steps to ensure that the HIPAA breach notifications are prioritized.”

The webpage updates address questions OCR has received concerning who is responsible for performing breach notification to HHS, affected individuals, and where applicable the media. Specifically, the FAQs make clear that:

• Covered entities affected by the Change Healthcare breach may delegate to Change Healthcare the tasks of providing the required HIPAA breach notifications on their behalf.
• Only one entity – which could be the covered entity itself or Change Healthcare – needs to complete breach notifications to affected individuals, HHS, and where applicable the media.
• If covered entities work with Change Healthcare to perform the required breach notifications in a manner consistent with the HITECH Act and HIPAA Breach Notification Rule, they would not have additional HIPAA breach notification obligations.

The new and updated FAQs on the Change Healthcare Cybersecurity Incident may be viewed at: https://www.hhs.gov/hipaa/for-professionals/special-topics/change-healthcare-cybersecurity-incident-frequently-asked-questions/index.html.

The HHS Breach Portal: Notice to the Secretary of HHS Breach of Unsecured Protected Health Information may be found at: https://ocrportal.hhs.gov/ocr/breach/breach_report.jsf.

OCR is committed to enforcing the HIPAA Rules that protect the privacy and security of peoples’ health information. Guidance about the Privacy Rule, Security Rule, and Breach Notification Rules can also be found on OCR’s website.

If you believe that your or another person’s health information privacy or civil rights have been violated, you can file a complaint with OCR at https://www.hhs.gov/ocr/complaints/index.html.

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For Political Types:  NY Focus story on Senate Working Rules Committee

https://nysfocus.com/2024/05/30/secret-senate-committee-working-rules-group

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Crain’s Health Pulse, 6/3:  

Teens bear the burden of City’s Mental Health Crisis

Nearly half of New York City teens reported at least some symptoms of depression or anxiety in the last few years, indicating a need for investment in youth mental health prevention and treatment, a new Health Department report says.

Forty-eight percent of kids between 13 and 17 years old experienced at least minimal symptoms of depression, according to a report on the state of the city’s mental health crisis released by the Department of Health and Mental Hygiene Friday. Rates of depression ranged by severity, with 27% of teens reporting mild illness while 11% reported severe disease.

Teens also showed more early signs of depression; 38% of kids in public high schools experienced feelings of sadness or hopelessness, up from 27% a decade ago, the report said.

Those early symptoms were even more prevalent among kids in marginalized groups. Black and Latino students reported higher rates of sadness and hopelessness than their white peers. Teens who identified as gay, lesbian, bisexual or transgender experienced those feelings at roughly double the rate as youth who did not identify with those groups.

“What we see in the data is that mental health is neither static nor homogenous,” City Health Commissioner Dr. Ashwin Vasan said in a statement, adding that the statistics depict a crisis that’s worse in some communities compared to others.

The Health Department released the report, which it described as a first-of-its-kind look into the city’s state of mental health, as Mayor Eric Adams’ administration faces pressure to mitigate the mental health crisis. The city faces crisis-level overdose rates and worsening severe mental illness – challenges that have also impacted the city’s youth.

Adams released a mental health plan in 2022, designed to address severe mental illness and expanded that plan to increase prevention and treatment for youth and families. Mitigating the challenges among youth has become a cornerstone of the administration’s mental health approach, and last year the city launched a $26 million teletherapy platform with digital health firm Talkspace to increase teens’ access to therapy. Roughly 6,800 teens have signed up for the program since it launched in November.

Mental health struggles extend to New York City’s 6 million adult residents, with 23% experiencing a mental health disorder every year, the report says. An estimated 1.2 million New Yorkers have an anxiety diagnosis, and 732,000 struggle with depression.

The Health Department recommended that city officials invest in more preventative efforts, such as screening for substance use disorders and school-based mental health clinics, to intervene early in mental health challenges. The agency also pushed for payment reform and workforce incentives — initiatives that are more likely to be solved at the state level.

Dr. Jennifer Havens, chair of child and adolescent psychiatry at NYU Langone Health, said that increasing access to therapy through platforms like Teenspace and investing in school-based mental health clinics help to make mental health treatment more accessible and mainstream. But addressing the challenges capacity and quality of mental health services requires more funding for intensive clinical services.

“We don’t invest enough in the kid and family mental health system at the beginning of life,” Havens said.  “If we did that appropriately and effectively, we would have fewer sick adults.”