March 16, 2023

For those NYS Council members that missed our Thursday morning call today, I wanted to review the information I shared with members regarding the OMH Article 31 Safety Net Payments that are coming out this week for the 2020 CFR reporting period.

First, I am advised that you will receive a transmittal from DoH today or tomorrow, advising you of your 2020 Safety Net payment amount.  The transmittal apparently explains how the payment was calculated. Check your pending remittances in eMedNY and search for one that says ‘Safety Net Pool’.

Background:  Last year the state submitted and a SPA amendment was recently approved by CMS that changes the methodology for calculating this payment.  The objective was to change the requirements for eligibility beginning with the 2020 reporting year such that more providers would qualify for these funds. The SPA that was approved reduced the threshold for Article 31 participation from 5% uncompensated care by Medicaid volume, to 3%.  This means more providers qualified to take part in the Pool for the 2020 CFR Reporting Period.  However, the amount of funds available in the Pool for Article 31 providers did not increase ($17M).   As such, your upcoming payment for the 2020 CFR reporting period is likely to be less than you expected due to the methodology change in combination with no change to the amount of funds available in the Pool.

Directly below please find an excerpt from a longer email we sent to all members on February 6 about this change.  Also,  check your Inbox.  I am advised that you previously received a letter from DoH/OMH dated August 30, 2022 that explains the changes that have now been implemented to the Safety Net Pool.

Here’s the email address for the Clinic Restructuring mailbox for those who wish to dispute the payment ion coming from the state.  I am reminded that the payment is based on the information you provided on your 2020 CFR.  Once you have reviewed the information, if you have a question or you wish to dispute the payment amount, use this email address to speak to the state:   clinicrestructuring@omh.ny.gov

From: Lauri Cole <lauri@nyscouncil.org>
Sent: Monday, February 6, 2023 12:40 PM
Subject: OMH Indigent Care / Safety Net Pools: Inside & Outside the ’24 Exec Budget Proposal

Good afternoon,

We continuing to analyze the executive budget proposal and wanted to share the following information: 

Recently (and outside of the executive budget process) CMS approved a Safety Net Pool State Plan Amendment (SPA) submitted by NYS that continues the federal match of resources for OMH Outpatient Clinic providers who meet eligibility standards for reimbursement through the Pool.  The approved SPA ‘rationalizes the methodology to allow more providers to participate’.   That being said, it is still FFS dependent and linked.  Note:  The recently approved Pool expands access to care by lowering the threshold to participate in the Pool from the current 5% threshold to 3% to qualify, thereby opening up participation to more OMH Outpatient Clinics. 

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