May 4, 2022
The OASAS Webinar for Residential Providers (hosted by Pat Lincourt and Trisha Allen) concluded about an hour ago. There were no slides or materials provided to participants who attended the Webinar, however, OASAS has promised follow-up via a FAQ document that is based on questions received during the Webinar.
Note: As you may recall, the NYS Council hosted a Thursday morning Public Policy meeting about a month ago where Alan Maughan from OASAS was our guest speaker. At that time, Alan shared information from the attached document. Much of the information from today’s Webinar was discussed at our meeting with Alan last month, before the state budget passed.
Nevertheless, you can use the attached Rate Sheet to follow along with the information shared on the Webinar today (summarized below). Note: The Rate Sheet refers to the OASAS Outpatient Clinic Program by a new name – the OASAS Outpatient Addiction Rehab. Keep this in mind as you review the rates.
Editorial Note: The Webinar was a but rough. Lots of background noise and some confusion so please receive these notes as subject to my refinement as I continue to check my facts:
OASAS Webinar, 5/4
Two things happening:
1) OASAS has applied for but CMS has not yet approved a (OASAS) proposal that would set a Medicaid rate for 820 Reintegration programming.
2) OASAS has also submitted a 1115 waiver (IMD Exclusion) that seeks to pull in the rest of FFS programming into Medicaid managed care. Also not yet approved by CMS.
With CMS approval of #1 (above), there would be an enhancement for OASAS Reintegration Services. OASAS also has a longer term plan to support these services (not yet announced) to support this level of care. If you are certified as an 820 Reintegration Program (scattered site or congregate) you would get a new Medicaid rate as follows:
Pending Daily Rates (these have not yet been approved) for Reintegration Services:
- Upstate (does not include 50% enhancement) = $115.42
- Downstate (” “) = $135.03
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For the 820, new Stabilization Rates are as follows:
- (w/ 10% temp eFMAP enhancement) $166.68 Upstate
- (” “) $181.80 Downstate
For Rehabilitation Services:
- (w/ 10% temp eFMAP enhancement) $156.21 Upstate
- (w/ 10%temp eFMAP) $179.92 Downstate
Note: On 7/1/2022, these rates go back to the former unenhanced rates (no more 10% eFMAP enhancement)
Increased Outpatient Rates New rates are loaded and plans were notified of the rate changes in early March. The state must give the plans 60 days to load the new rates and then the plans must begin paying the new rates as of the effective date of the rate increases. If they fail to do so, they must pay you the new rate retroactive to the date the new rates became effective (mid-May) AND you may be able to recover interest (although this is a difficult fight).
As always, if you have questions, feel free to reach out to me at your convenience at 518 461-8200.