June 2, 2022

We are delighted to report that our bill to increase transparency in instances where the state amends the Model Contract has now passed in both houses of the NYS Legislature.  GO TEAM NYS COUNCIL!! 

Frankly, it’s been a while since we’ve seen a newly introduced bill move this quickly. In our experience, it usually takes two or three years to get a bill done.  We are incredibly grateful to the bill sponsors, Assemblyman Gottfried and Senator Rivera for championing this effort and frankly, for having our backs throughout the last two years as we fought to compel state regulators to enforce all of the laws and contract provisions required of MCOs and the state in Medicaid managed care.  Big thanks are also due to Marcy Savage, our government relations consultant from Reid, McNally and Savage who is relentless in her efforts to see our priorities become reality.

This bill came about as the result of what we learned through an extensive FOIL process we engaged in several years ago to determine whether the state was enforcing all of the laws and contract provisions that are in place to protect consumers and providers in Medicaid managed care.  In that process, we learned that the state had made retroactive changes to the Model Contract – a document that lays out the contractual requirements on the state and MCOs in the carve in of BH services to Medicaid managed care.  The changes the state made in 2020 were retroactive and they run contrary to the formal agreements made by a broad range of stakeholders assembled in 2014-2015 to establish the rules for the carve in of our services.  We think any future changes made by the state (as well as the changes it made retroactively in 2020) should be made public.  And while we were incredibly pleased to see funds paid to certain MCOs that did not meet expenditure targets recouped and returned to OASAS and OMH, we felt an obligation to ensure that whenever changes such as those made by the state in 2020 are made, they are made public in a timely manner.

Thank you for supporting this bill.  I should mention that in recent conversations with government entities, we have encountered some verbal pushback to the requirements of the bill.  We see the requirements as incredibly minimal.  Nevertheless, we will need all hands on deck to ensure the Governor’s signature on this bill.  We can see no reason why she would hesitate to enact this legislation, given her clear commitment to transparency in all areas of state government.  Governor Hochul assisted us in curing the problem we discovered last year in which (under the previous administration) the state had failed to enforce expenditure targets.  We remain grateful to her for her swift action in that instance, and we look forward to her signing this bill to ensure a transparent playing field going forward.