NYS COUNCIL BRIEFING RE: IMD Waiver proposal

October 27, 2022

Yesterday, DoH, OMH and OASAS held the first of two public meetings to discuss the state’s proposed IMD Transformation Program waiver.  The NYS Council previously sent the information (directly below) to all members in anticipation of this proposal:

We want to share some important information with all NYS Council members regarding the impact of the proposed waiver (should it be approved by CMS) on OMH and OASAS Programs and Services. 

First, the proposed waiver would not directly impact the OMH Community Residence Program.  It would impact OMH (State) Psychiatric Centers.  The waiver would impact OASAS ATCs, community based OASAS Inpatient Programs and community based OASAS 820 Residential Services.   But, according to DoH, the state has already calculated all of the OASAS impacted Programs and Services and averaged the COMBINED length of stay for ALL and has found that the average length of stay is less than 30 days.  According to DoH, OASAS 820 residential providers will NOT have to reduce LOS to meet a 30 day LOS requirement.  For this Waiver, the calculation is based on ALL of the impacted OASAS Programs and Services, not any one program.   Programs like inpatient detox, community detox and others OFFSET the longer lengths of stay associated with OASAS Residential 820 programs.

Currently OASAS 820’s can bill Medicaid managed care for these services however, at the present time, these programs can not bill Medicaid for FFS clients due to IMD rules.  The IMD Transformation Waiver that is being proposed would permit the impacted 820 Programs and Services to receive federal share and therefore bill Medicaid FFS.  

Finally, according to DoH, the IMD Transformation Waiver would allow the state to receive bill federal Medicaid match for 816 community detox, and 818 community based inpatient rehabilitation programs (including ATCs).  At the present time, these programs bill Medicaid but it is state-only dollars.  If approved, The Waiver would permit the state to draw down federal funds for these services.  We urge all members to review the information linked at the top of this email.  The second public meeting on this topic will be held on Monday, October 31.  Below is a Notice previously sent to all providers from OASAS (and the NYS Council).

Please Note:  We make no claims that we understand every aspect of this proposal, however, we wanted to get clear about the impact on some of our OASAS Residential Programs quickly.
More to follow.  L.

Dear OASAS Provider:

  • The New York State Department of Health (DOH), Office of Mental Health (OMH), and Office of Addiction Services and Supports (OASAS) are pleased to announce that they will conduct two virtual public hearings to provide an overview of the State’s IMD Transformation Demonstration Program waiver amendment request and allow members of the public to provide comments.
  • The 30-day public comment period for this waiver begins October 5, 2022, and will close on November 4, 2022. In addition to this 30-day comment period where the public will be afforded the opportunity to provide written comments, the agencies will be hosting two virtual public hearings during which the public may provide oral comments. Any updates related to the public hearings will be sent via the OMH and OASAS Listservs.
  • The two virtual public hearings will be held as follows. Please also see the attached PDF announcement for complete details.

1. First Public Hearing Wednesday October 26, 2022, 3:30 pm – 5:00 pm . Pre-registration is required for anyone wishing to attend the hearing using this link: https://meetny-events.webex.com/meetny-events/j.php?RGID=ra4ca24a1a9e2e60ef935eb4172291e33. All registrants will receive an automated email confirmation of their registration.

2. Second Public Hearing Monday October 31, 2022, 11:00 pm – 12:30 pm . b. Pre-registration is required for anyone wishing to attend the hearing using this link: https://meetny-events.webex.com/meetny-events/j.php?RGID=r6a567861b36b3235b79c08dbce775a52. All registrants will receive an automated email confirmation of their registration.