August 15, 2025
Yesterday I sent the request below to hundreds of NYS Council billers, coders, revenue cycle managers and others who are involved with the NYS Council’s Billing Geeks group. The group has been meeting together for over 5 years and each Wednesday morning over 100 ‘Geeks’ (I say this lovingly) meet to share information, problem solve and support each other given the many complexities associated with performing their primary tasks and responsibilities. It’s a fantastic resource and we are proud to support your key staff in this manner.
Help us prioritize completion of the Survey by next Friday (see below email) The only way we will compel state leaders to fix the problems we continue to have with non-compliant commercial insurers is to collect data and talk very publicly about the many ways regulators are failing in their responsibilities while insurers continue to stall, deny, and make up the rules rather than complying with the new law that was effective January 1, 2025.
Second Survey
Next week we will send all NYS Council members a second survey that collects information regarding your Medicaid managed care issues and experiences. We administered the same survey to all members three years ago. Now we need to update our data in order to wage a potent advocacy campaign in support of our legislation (sponsored by the Mental Health Chairs in the Senate and the Assembly) that would carve out OASAS and OMH outpatient services (only those services that can be carved out without threat to the program in question). I know this is a challenging time of year to complete surveys given scheduled vacations and ongoing workforce challenges but your participation is essential. You will have the survey on MMC by Tuesday, August 19 with a two week turnaround time frame. Stand by.
Thank you in advance for your ongoing partnership!
Lauri
———- Forwarded message ———
From: Lauri Cole <lauri@nyscouncil.org>
Date: Thu, Aug 14, 2025 at 12:20 PM
Subject: NYS Council Commercial Insurance Survey
To:
Good afternoon,
As we have discussed during our last few Billing Geeks meetings, today the NYS Council is seeking your assistance in documenting and quantifying the extent of problems and challenges facing mental health and substance use disorder providers serving New Yorkers covered under a fully-funded commercial insurance policy.
Last year the NYS Council compelled government leaders to enact Part AA – the new Commercial Rate mandate that was included in the ’24-’25 state budget. The new Law became effective on January 1, 2025 and at the present time, OASAS and OMH providers that serve New Yorkers covered by a fully funded commercial insurance policy that is effective in 2025, are entitled to reimbursement at (atleast) the Medicaid APG government rate, while the first cohort of CCBHC Demo agencies are entitled to receive the equivalent of their PPS rate for these services. You must be ‘in network’ with the commercial insurer you are billing in order to qualify for the new rates.
We want to know more about your experience to this point. We will use this information (without using any provider names or specific identifying information) in our continuing advocacy to push the state to do its job to enforce the law as enacted. We need data to strengthen our arguments. Please return this survey by next Friday, August 22 at the latest. The Survey is at this link:
https://www.surveymonkey.com/r/LTK7XVZ
If you have questions please call me at your convenience at 518 461-8200.
PLEASE help us to help you with this ongoing and serious problem.
Thank you!
Lauri