July 2, 2024
Good morning,
Please note: The NYS Council will be closed on July 4th. As such there will not be a NYS Council Member Support and Public Policy call this Thursday. Happy 4th to all!
1) Please see the article below regarding a growing coalition of NY businesses and other entities that are opposing New York’s plan to implement the $4B Managed Care (MCO) Tax that (if implemented) would allow NYS to use the funds generated from the tax for investments in various areas of New York’s healthcare system. Many of these investments were articulated in the recently enacted state budget.
The NYS Council first informed our members re: the MCO Tax well before it became public knowledge and based on information we received that described an idea to generate additional Medicaid dollars that can sit outside the rigid rules for how much NYS can spend on its Medicaid Program from quarter to quarter, year over year. We described the MCO Tax in detail, citing numerous states that already utilize it to generate additional scarce resources that are then reinvested. In this scenario the state taxes the MCOs and then pays them back with funds that are generated as the result of the state receiving a federal match for the funds. Considering that the rate increases that were enacted as part of the new state budget rely to some degree on this new income, the implications associated with New York’s failing to receive federal approval for the Tax could be far reaching and would likely repress future state spending in future budgets.
2) We have heard (again) that we can expect a series of announcements from the Administration and specifically DoH this month regarding New York’s new 1115 waiver.
Attached please find the brochure for the 2024 United Hospital Fund Conference where NYS Medicaid Director Amir Bassiri will deliver a keynote address. Typically the keynote at the UHF Conference is an opportunity for the State Medicaid Director to educate stakeholders regarding various initiatives and (in the recent past) to make announcements regarding movement on major projects such as NY’s new Waiver.
3) On June 27th, CMS approved New York’s SPA to update the fees for the Health Home Serving Children (HHSC) program and add an additional tiered fee for HHSC programs that are designated to provide High Fidelity Wraparound (HFW) services. The updated rates, which are effective retroactive to January 1, 2024, are attached along with the SPA and the CMS approval letter. 4) The NYS Council submitted comments to OMH Counsel’s Office regarding a Proposed Rule published in the May 1, 2024 NYS Register. The Rule informs the public that the Office intends to amend its regulations to raise the caps on the amount of primary care services an Article 31 outpatient clinic can deliver (without needing to obtain an Article 28 license) from 5% to 30% (by annual Medicaid volume). As we noted last week, OASAS did not need to publish a Proposed Rule since its regulations do not speak to a cap; however, the same increase from 5% to 30% is planned for OASAS Article 32-Part 822 clinics once the policy change is implemented.
Coalition to Hochul: Reject $4 billion tax on managed care organizations