June 22, 2024
Did you know that CMS recently approved a New York State SPA that adds OASAS RSSY Services to the NYS CHP Benefit Package, to be paid at APG government rates?
On June 10th, CMS approved New York’s State Plan Amendment (SPA) #NY-24-0037-CHIP, to add Office of Addiction Services and Supports (OASAS) Residential Rehabilitation Services for Youth (RRSY) provided via Part OASAS 817 programs to the CHP benefit package. The SPA is effective retroactive to April 1, 2023. The NYS Council will check in with OASAS on Monday to ascertain next steps for impacted providers. The SPA and the CMS approval letter are linked here.
Background: It should be noted that in 2013, NYS Council advocacy resulted in a new statutory requirement for MCOs to pay APG Government Rates for a wide variety of OMH and OASAS mental health and substance use disorder services; however, it failed to include Child Health Plus services at that time. In 2015, NYS Council closed the loop, successfully advocating for the inclusion of CHP services to the group of services to be paid at the mandated ‘government rate’.
According to the SPA, the CMS approval includes all services provided by RRSY under OASAS Part 817. These services include, but are not limited to, clinical services, recovery support services, educational and vocational assessments and services, Medication for Addiction Treatment (MAT) and food and nutrition services. Clinical services include individual, group, and family counseling, assessment and referral services for patients and significant others (e.g., parent/guardian(s), sibling(s), partner(s), etc.), medical and psychiatric consultation, and HIV and AIDS, hepatitis C, tuberculosis, and other communicable diseases education, risk assessment, supportive counseling and referral. Services must be clinically indicated and specified in the individualized treatment/recovery plan and/or progress notes. Services shall be reimbursed in accordance with government rate-setting methodology.