November 14, 2025

FEDERAL STOP GAP FUNDING: SUMMARY & BILL TEXT

On Wednesday, Nov. 12, Congress passed a government funding package ending the longest shutdown in history. The bill passed the Senate by a vote of 60-40 and the House by a vote of 222-209.  

The bill (summary here, and full text here) will extend current funding levels for most federal agencies and programs through Jan. 30, 2026. The funding package includes three full-year appropriations bills that will fully fund the Department of Agriculture, Food and Drug Administration, Department of Veterans Affairs, military construction projects and operations of Congress through Sept. 30, 2026.

The bill guarantees back pay for furloughed workers, requires the administration to rehire federal workers who were laid off through reduction in force (RIF) efforts since Oct. 1, and prevents future RIFs during the CR (through Jan. 30, 2026).

Notably, this bill progressed despite lacking any extension of the Affordable Care Act premium tax subsidies (although Republican leadership has ‘promised’ a December vote). These subsidies will expire on Dec. 31 absent further congressional action prior to that date. Members of both chambers are continuing active negotiations over a possible extension of the subsidies.

The funding package also extends Medicare telehealth flexibilities through Jan. 30, 2026. This includes delaying the requirement that patients receiving mental health services via telehealth must have at least one in-person visit in the six months preceding their first telehealth appointment. We anticipate that telehealth claims that have been on hold may be paid retroactive to Oct. 1. However, the Centers for Medicare and Medicaid Services (CMS) will likely need to issue guidance clarifying whether these claims can be paid now, or if a provider rendered a service that held a claim on or after Oct.1, if it can now be submitted for reimbursement. We will keep you updated on any CMS guidance issued over the coming days.

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FEDERAL GOVERNMENT REOPENING & Impacts on TELEHEALTH

Telehealth providers are getting a wave of federal support as the government reopens, with Medicare clinicians set to receive back pay for services delivered during the 42-day shutdown and CMS preparing guidance on claims. At the same time, the DEA is poised to issue another temporary extension of pandemic-era flexibilities that allow prescribing Schedule 2–5 controlled substances via telehealth without an in-person visit. The forthcoming “Fourth Temporary Extension” is expected to be a clean one-year continuation, offering the industry breathing room while the DEA and HHS determine a long-term framework. The move comes amid uncertainty over future rules, after a Biden-era proposal that would have sharply restricted tele-prescribing drew strong backlash for threatening to shut down many virtual care providers. (Article here)
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NEW RESOURCE!

We The Action:  A FREE Legal Aid Network for Nonprofits

https://nonprofitquarterly.org/we-the-action-a-free-legal-aid-network-for-nonprofits/?utm_campaign=shareaholic&utm_medium=copy_link&utm_source=bookmark

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Notice from OMH

Attached is a list of OMH contracts that are currently with providers for review or signature. 

There are five tabs:

• • Provider Review Required – These are contracts that have been created in SFS by Central Office and providers may now add their workplans and budgets.

• • Provider Signature Required – These are completed contracts that are ready for providers to sign and return to Central Office.

• • There are three new tabs designed to let providers know if they have expired documents. We cannot execute contracts with expired documents. Please encourage them to updated documents to their field office contacts.

    • • VRQ Expired

      
      

      • Workers Compensation Insurance Expired

      
      

      • Disability Benefits Insurance Expired

    
    

OMH advises providers to contact their field office with questions/concerns. 

Please note this report is sent weekly and reflects contract status as of today. SFS is updated daily as tasks are completed.

Please be advised that CBR Technical Assistance meetings have been cancelled due to minimal provider involvement.

Guidance and training materials, including PowerPoint slides, a recorded training video, and a link to the technical assistance meeting, are now available on the https://omh.ny.gov/omhweb/finance/cbr-training.htm web page.  Please feel free to forward this information to anyone in your organization you believe would benefit.

Thank you,

Alec Chakery

Contract Management Specialist 1 Trainee

Office of Mental Health

518-474-8578

Alec.Chakery@omh.ny.gov

www.omh.ny.gov

BRUCE BLAKEMAN WEIGHS PRIMARY CHALLENGE to STEFANIK IN GUBERNATORIAL RACE,  VISITS ALBANY

Gift Article:  

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RECENT CLASS ACTION SETTLEMENT IMPACTING CHILDREN’S MENTAL HEALTH SYSTEM

Dear NYS Children’s Mental Health Stakeholder,

As a follow up to the Departments’ communication to you last month, providing notice of a settlement of the matter of C.K. v. McDonald et al., please find attached a Supplemental Joint Stipulation of Settlement, General Release, and Order of Dismissal regarding Attorneys’ Fees.

Please note that this supplemental agreement pertains to attorneys’ fees settled in this matter and all other instructions contained in our prior communication and the notice still stand.

Thank you,

Meredith Ray-LaBatt, MA, MSW                    April Hamilton, MBA, MHSA

Special Advisor to the Commissioner            Executive Deputy Director, DPDM, OHIP

NYS Office of Mental Health (OMH)              NYS Department of Health (DOH)

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MEDICAID AND ‘ILLEGAL IMMIGRANTS’ HEALTHCARE

The Guardian: Medicaid head falsely claims $1bn is being spent on healthcare for ‘illegal immigrants’, say experts
The administrator for the Center for Medicare and Medicaid Services (CMS), Mehmet Oz, recently claimed that an audit revealed “more than $1bn of federal taxpayer dollars were being spent on funding Medicaid for illegal immigrants”, but experts say the audits were unrelated to immigration, and that rhetoric like this could make immigrant families – regardless of legal status – afraid to seek necessary medical care. Leo Cuello, a research professor at Georgetown University’s Center for Children and Families, noted that he has not “seen what this audit is”, but “based on the reporting, it appears that it is related to administrative errors in state claiming for matching funds, which is a relatively common occurrence, and which CMS monitors closely as they should”. For example, it is common for states to ask for federal reimbursement for programs that are supposed to receive state funding exclusively, such as Meals on Wheels. Cuello said these types of audits are “the most vanilla and normal thing that happens all the time. States are constantly sending CMS claims, and CMS is constantly reviewing whether or not they’re paying something properly.” Reporting from Oregon Live and KFF confirms that the audits were routine. What is not normal is for a CMS administrator, like Mehmet Oz, to post about these audits on social media, Cuello said. In his X post, Oz claimed that “Democrats are demanding the repeal of the President’s Working Families Tax Cuts legislation in order for their votes to reopen the government. This law wisely strengthened our ability to limit federal dollars from being spent on health care for illegal immigrants.” “The Oz tweet mixes apples and oranges because it talks about a very specific audit, but then tries to put that audit into the context of the broader fight about HR1 [the One Big Beautiful Bill Act] and the Affordable Care Act enhanced premium tax credits and the shutdown,” Cuello said. But, Cuello added, these audits and the shutdown are completely unrelated.“More importantly, the Oz tweet repeats an inaccuracy that has been said numerous times at this point,” he continued, which is that Republicans are pushing the One Big Beautiful Bill Act and Affordable Care Act tax credit repeals in order to limit health coverage for undocumented immigrants. These measures would primarily remove coverage for US citizens, not undocumented immigrants, Cuello said. The CMS did not respond to the Guardian’s request for comment. (Harris Green, 11/10) 

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RURAL HEALTH TRANSFORMATION PROGRAM

The Talking Points Memo: Only a Fraction of Republicans’ Much-Touted $50 Billion Rural Health Fund Can Help Struggling Hospitals Pay Their Bills
As President Donald Trump’s deadline for a massive budget bill drew near early in the summer, Republican Senate leadership needed to corral the support of some members of the conference. The bill would help pay for tax cuts for the wealthy partly through cuts to Medicaid and needed nearly all Republican votes to pass. The impact on rural hospitals, analysts warned, would be severe. But Republican leadership was able to win over key votes by directing a small slice of money to a “rural hospital fund.” Now, all 50 states are now vying for a piece of that $50 billion fund, billed as a savior for floundering rural hospitals — and a backstop against the harmful impacts of the now-passed, historic cuts to Medicaid. The fund, and its application process which closed last Wednesday, has been called “the rural health ‘Hunger Games.’” States are in a mad dash for a slice of the investment. Despite that, due to Trump administration restrictions on how the fund can be used, advocates now say that hospitals will not be able to spend it in the areas they most need to address.

Under Centers for Medicare and Medicaid Services rules for distributing the funds, only 15% of any money awarded to states from this fund can be used to cover unpaid patient care, a major funding shortage for rural hospitals. “If enough people keep coming in who can’t pay their bills, the hospital can’t just survive on nothing,” Adam Searing, an attorney and research professor at the Georgetown University McCourt School of Public Policy, told TPM. “That’s why we have more hospitals closing in non-Medicaid expansion states than elsewhere and this is just going to make that program worse.” The grant funding will be distributed to states whose applications are approved by CMS over a five year period. Half of the $50 billion will be distributed equally to all approved applications. The other half will be distributed based on a complex weighted formula under which a range of policy-based factors account for about 15% of a state’s score. Some of those factors, advocates note, have a partisan valence. “We have an administration which just says right out, ‘We’re gonna cut money to blue states and blue communities,’ and it is doing it,” Searing said. “If you happen to live in a community that we disagree with politically, too bad.”In the meantime, more than 300 rural hospitals are immediately at risk of closure, and more than 1,000 are at risk in general as of October 2025, according to an analysis by the Center for Healthcare Quality and Payment Reform’s rural hospitals initiative. More than 75% of the hospitals in either category are in states that went for Trump in the 2024 presidential election. Yet the $50 billion fund is largely designed not for shoring up hospitals budgets left by the Medicaid cuts and other gaps in patients’ ability to pay, but for state spending on workforce recruitment and retention, modernization and technological advancement initiatives, and preventative care. The initiatives are mostly things that, barring historic health care cuts, Searing said would garner bipartisan support. (Jones 11/11)