August 1, 2023
Medicaid managed care: Citations and Enforcement Since 2019, over 200 citations have been issued by DoH/OMH/OASAS against various MCOs participating in the carve-in of behavioral health services, as result of a Root Cause Analysis performed (by the state) due to numerous complaints filed by behavioral health providers. The citations are posted here: https://www.health.ny.gov/health_care/managed_care/reports/focused_surveys/behavioral/index.htm
Also, the state recently completed enforcement actions against 5 insurers that settled with the state after (as I understand it) numerous failures to take corrective action as required. The insurers are required to pay fines (civil penalties). The enforcements are directly related to the Root Cause Analysis (mentioned above) that resulted in significant findings in three categories: 1) failure to pay government rates, 2) failure to oversee the vendor, and 3) inappropriate administrative claims denials. Here’s a link to the page on the DoH Website where you can read the enforcement agreements:https://www.health.ny.gov/health_care/managed_care/reports/focused_surveys/behavioral/index.htm
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New Media Campaign to Highlight Addiction Awareness
A new statewide media campaign has been launched to raise awareness of addiction, and services available in New York State for those impacted by addiction and their families, Gov. Kathy Hochul announced Monday. The campaign is designed to educate the public about the potential risks of fentanyl, as well as the importance of harm reduction services, and how and where to find help for addiction in New York, according to the release.
Here’s more:
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Opioid Settlement Fund: Documents from July 2023 Opioid Advisory Board Meeting Now Posted
For more information to include supporting documents reviewed during the July ’23 Opioid Settlement Fund Advisory Board meeting, scroll down to the meeting materials posted at this link: https://oasas.ny.gov/opioid-settlement-fund-advisory-board
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New Resource:
HMA Webinar Replay: New Tools for Behavioral Health Services Through the Medicare Programhttps://www.healthmanagement.com/insights/webinars/new-tools-for-medicare-policy-changes-impacting-behavioral-health-services/